Director of Risk Adjustment
Virtual Vocations Inc
Leading product strategy for a vital technology platform, the full-time salaried Director of Risk Adjustment will define and execute the product roadmap, enhance clinician experience, and ensure compliance with CMS regulations while working remotely. Key responsibilities Defining and executing the product roadmap for risk adjustment workflows Driving enhancements within the careflow platform to improve documentation quality Collaborating with cross-functional teams to translate regulatory changes into product strategy Required qualifications 5+ years of Product Management experience 2+ years of experience in healthcare payer, value-based care, or Risk Adjustment Deep understanding of HCC coding and CMS Risk Adjustment models Experience with healthcare interoperability, including APIs and HIEs Strong analytical skills with experience in interpreting operational KPIs
$130k - $150k
Role Description Job Description: Director of Risk Adjustment ~Strategic Client Management: ~Serve as the primary operational partner for multiple external clients across medical groups, health systems, and risk-bearing entities. ~Serve as the trusted advisor and...SuggestedFull timeWork experience placement- ...communities we serve strengthens our ability to deliver on that commitment. We have an opportunity to join the Alliance as the Risk Adjustment Director leading the Risk Adjustment Department. This position can be located in one of our service counties (Mariposa, Merced...SuggestedFull timeContract workTemporary workPart timeLive inWork at officeLocal areaRemote work
$190.9k - $265.55k
...This position will lead the data, analytics and modeling work for the Enterprise Risk Adjustment department responsible for overall strategy and implementation of data, reporting, and model development including actuarial work product like forecasts, valuation, and pricing...SuggestedFull timeWork experience placementLive in- Role Description Director, Product Manager - Risk Adjustment (Remote) About the Role: ~Type: Full-Time, Salaried ~Compensation: $152,000-$183,000, 20% bonus ~Location: Fully Remote (must be located in the United States) ~Hours: Full-Time, Days What to...SuggestedFull timeTemporary workRemote workFlexible hours
$100k - $231.54k
Role Description Revenue Integrity Informatics is seeking a Lead Director, Informatics to lead Medicare Advantage and ACA risk adjustment analytics, predictive modeling, intervention strategy, and financial valuations. This role is responsible for driving risk score accuracy...SuggestedHourly payFull timeTemporary workWork experience placement$170k - $225k
Role Description The Director, Risk Adjustment Products will lead the strategy, roadmap, and execution for the product portfolio focused on retrospective risk adjustment solutions. This is a leadership role where you will pair your product development and people management...Full timeRemote work- ...Remote - Must Reside in the State of Florida) Status: Full Time, Salaried Shift Hours: M-F, 8:00 am - 5:00 pm The Manager Risk Adjustment Program: Leads and implements risk adjustment strategies, operations and program development across BayCare PHSO and BayCare...Full timeRemote workShift work
$198.22k - $297.33k
Role Description The Sr. Director, Risk Adjustment Data & Analytics (Remote) is a senior technical and operational leader responsible for advancing the integrity, completeness, and strategic value of Medicare Risk Adjustment (MRA) data and analytics programs within the...Full timeWork experience placementRemote work- ...Description :This professional position is assigned the responsibility and accountability to manage and coordinate the risk adjustment programs for Cox HealthPlans (CHP). This manager will work with other staff and leaders within CHP to ensure risk-adjusted revenue...
- ...Massadvantage in Worcester, MA is seeking a Manager of Risk Management to oversee Medicare risk adjustment activities. This role involves driving strategies, ensuring compliance, and interacting with vendors and providers. Ideal candidates will have at least 7 years in...
- ...Customer Success Manager - Healthcare Risk Adjustment Remote Opportunity About Reveleer Reveleer delivers a unified platform spanningrisk adjustment,quality improvement,clinical intelligence, andmember managementfor health plans and provider organizations navigating the...Work experience placementLocal areaRemote workFlexible hours
$175k - $275k
The Role We are seeking an exceptionally skilled Risk Manager to serve as a key member of our DMFI Credit team based in New York City... ...hedge fund that strives to deliver industry-leading risk-adjusted returns for our investors. We leverage both internal and external...Full time- ...Job Description Job Description Manager of Risk Adjustment Upward Health is an in-home, multidisciplinary medical group providing 24/7 whole-person care. Our clinical team treats physical, behavioral, and social health needs when and where a patient needs help....
- ...Memorial Health providers with their patients’ needs in mind. We are looking for a Manager of Risk Managment to oversee Mass Advantages's full suite of Risk Adjustment activities. This position is responsible for the strategy, execution and performance of Medicare...Work at office
- ...Director of Risk Management Corporate Texas - Houston, TX 77094 Overview Level Management Category Management Description... ...and emergency protocols. Schedule site inspections with adjusters and insurance providers and ensure onsite and corporate teams...
- ...occur in providing appropriate medical care. Liaison between adjuster, treating physicians, nurse case manager and attorney. Negotiate... .... Develop new equipment, tools and or processes to reduce risk of injury. Establish, maintain and implement safety training...Local area
- ...Director, Risk Management The Director, Risk Management develops, recommends and administers a risk management program that will effectively... ...all Auto and General Liability claims; provides authority to adjusters; directs funding for claims payments for all claims including...Full timeFlexible hours
$141.7k - $233.9k
...We are recruiting for a mission-driven Director of Healthcare Risk Management to join our team! We're with you for life's journey. At Denver... ...claim/insurance managers, insurances carriers, brokers, and adjusters, ensure early and timely identification, investigation,...Work experience placementWork at officeImmediate startShift work- ...Job Title: Director of Risk Management Department: Risk Management Location: Houston or Dallas (Hybrid) Position Type: Full... ...maintain strong relationships with insurance brokers, carriers, adjusters, attorneys, TPAs, vendors, and operational leaders to ensure...Full time
- ...personal service. Alliant is changing the way our clients approach risk management and benefits, so they can capitalize on new... ...revisions to improve loss prevention. Coordinates with claims adjusting staff to effectively investigate and address losses and prevent...Contract workLocal areaImmediate start
$151.6k - $285.6k
...global team of industry experts in strategy, marketing, operations, risk, money movement and digital consulting, with decades of... ...including policy frameworks, modeldriven decision logic, model adjustment tools, and governanceready artifacts to support issuer underwriting...Work experience placementWork at officeLocal areaFlexible hours- ...partners; recommend and implement new partnerships to improve risk controls and metrics. Responsible for planning, monitoring,... ...acquisitions process. Conduct regular policy reviews with third party adjusters, insurance carriers, and/or external vendors. Elevate the...
- ...Highmark Inc. is seeking a Director of Strategy for Risk Adjustment (RAAM) to shape strategic direction, oversee critical programs, and coordinate cross-functional teams to optimize risk adjustment accuracy. The role emphasizes performance reporting, budget oversight,...Remote workFlexible hours
$142k
...Company : Highmark Inc. Job Description : JOB SUMMARY The Director of Strategy for Risk Adjustment (Risk Adjustment Accuracy Management (RAAM)) plays a pivotal role in driving the strategic planning, operational efficiency, and programmatic execution within the RAAM department...For contractorsWork at officeLocal areaRemote work- ...and providers to perform, document and regularly update client risk assessments Review and manage all insurance applications and renewals... ...and identify any changes in risk profiles that may require adjustments to coverage or premiums Summarize the nature of policies,...Work at office
- ...Description Job Description JOB DESCRIPTION JOB TITLE: Sr. Manager, Risk Adjustment FLSA STATUS: Exempt DEPARTMENT: Quality Improvement and Risk Adjustment REPORTS TO: Sr. Director, Quality Improvement, Risk Adjustment, and Health Analytics AUTHORITY:...Work at officeShift work
$164k - $246k
...Serving as a trusted partner to Technology Directors, portfolio owners, business leaders, and... .... The role also manages portfolio-level risks, dependencies, financial performance,... ...law. If you require assistance and/or adjustment to participate in our application and/or...Full timeContract workWork at office- ...Pacific Asset Management, LLC is actively seeking a talented Director, Quantitative Investment Modeling & Support to join our Investment Risk Team in Newport Beach, CA. In this role, you will develop, validate, and quantify cashflow models for complex and illiquid asset...Full time
- ...Risk Adjustment Compliance Manager Location: This role requires associates to be in-office 1 day per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office...Full timeTemporary workWork at officeLocal area1 day per week
- ...needed. Specific vision abilities required include close vision, distance vision, peripheral vision, depth perception & the ability to adjust focus. The requirements listed above are representative of the knowledge, skills &/or abilities required for this position....Contract workWork at officeFlexible hours
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