Medicaid Risk Adjustment Market Lead
$54.3k - $145.86kHispanic Alliance for Career Enhancement
CVS Health is seeking a Medicaid Market Manager to drive engagement in risk adjustment programs. This high-visibility role requires 5+ years in healthcare operations and strong qualitative skills. The ideal candidate will manage project execution, lead market meetings, and analyze performance data to deliver actionable insights. Responsibilities include creating executive presentations and collaborating with clinical teams to improve outcomes. A Bachelor's degree is needed, along with proficiency in MS Excel and PowerPoint. The position offers a comprehensive benefits package and a salary range of $54,300.00 - $145,860.00. #J-18808-Ljbffr Hispanic Alliance for Career Enhancement
$54.3k - $145.86k
...motivated and strategic professional to serve as the Medicaid Market Manager for our Risk Adjustment programs. This is a high‑visibility role responsible for... ...measurable impact. The individual in this role will lead monthly market meetings, translate performance data into...RiskFull timeWork experience placementLocal area- ...across the ACA Marketplace, Medicare, and Medicaid. NeueHealth delivers clinical care to... ...for all. Centrum Health’s Sr. Manager of Risk Adjustment and Quality will be responsible for... ...records, coding, and billing operations. Lead a team to drive risk adjustment performance...RiskTemporary workWork at office
$20 per hour
...We are looking for a Risk Adjustment Analyst to join our team to train AI models. You will measure the progress of these AI chatbots, evaluate their logic, and solve problems to improve the quality of each model. In this role, you will need to be an expert in healthcare...RiskHourly payFull timePart timeFor contractorsRemote workFlexible hours- A valued healthcare provider is seeking a Sr. Manager of Risk Adjustment and Quality in New York to lead risk adjustment operations, manage a team, and ensure regulatory compliance. The role requires strong leadership, extensive experience in healthcare risk adjustment,...Risk
$54.3k - $145.86k
...Leadership: Manage assigned territory within the risk adjustment program from planning through completion, including leading cross-functional meetings, setting timelines,... ...Cross-Functional Collaboration: Partner with Market/Network teams and Provider Relations to align...RiskHourly payFull timeTemporary workLocal areaRemote work- Cano Health is seeking a Risk Adjustment Coder responsible for identifying, documenting, and coding claims. The ideal candidate will have at least two years of medical coding experience and relevant certifications such as CPC, CPC-A, CCS-P, or CRC. Proficiency in Microsoft...RiskFlexible hours
- Position The Risk Management Division is actively seeking an All Lines Claims Adjuster. Benefits Employees receive low or no cost health insurance options, dental, vision, life insurance, flexible spending plans, twelve paid holidays, a personal leave day, and Federal...RiskWork at officeLocal areaFlexible hours
$88k - $122k
Sedgwick is seeking a Commercial General Liability (CGL) Claims Adjuster to handle complex bodily injury and property damage claims in Town... ...skills in coverage analysis, litigation management, and risk transfer strategies. Qualifications include a Bachelor's degree,...Risk$54.3k - $145.86k
...Health, located in New York, is seeking a candidate for a full-time remote position focusing on project leadership within the risk adjustment program. Responsibilities include managing chart retrieval processes, engaging with providers, and data analysis to achieve organizational...RiskRemote jobFull time$75k - $92k
...insurance needs of the wheels‑based transportation industry. We offer risk financing solutions across all 50 states, including traditional... ...and alternative risk transfer programs. Position Workers Comp Adjuster – fully remote (USA) Essential Job Functions And...RiskFull timePart timeSeasonal workRemote work- ...responsible and accountable for initiating and leading the development of actuarial studies,... ...economics, profitability analysis, risk adjustment, predictive modeling, and/or claim... ...leveraging public methodologies (e.g., Medicaid, Medicare, Marketplace) as well as proprietary...RiskContract workWork at officeRemote work
- ...appropriate mitigation/remediation is performed. Communicate with the adjuster team handling the claim and their management. Negotiate with... ...to pursue and hire these candidates without financial obligation to recruiters or agencies. #J-18808-Ljbffr Windward Risk ManagersRiskCurrently hiringVisa sponsorship
- ...data and advanced AI to surface risk, automate compliance, and... ...across Sales Engineering, Product, Marketing, Customer Success, and more.... ...of high‑potential accounts and lead with a consultative, strategic... ...is periodically reviewed and adjusted to align with evolving business...RiskRemote work
- ...Inhouse Counsel / Manager Legal, Compliance & Risk Management / Outpatient Clinics / Full-... ...healthcare laws (e.g., HIPAA, Medicare/Medicaid regulations) and employment practices.... ...employees. Violations of this policy will lead to disciplinary action, including termination...RiskFull time10 hours per weekShift work
- A Florida-based risk management company is seeking a professional to analyze and audit Mold Testing & Remediation protocols and water... ...experience in property claims and be licensed as a Florida All-Lines adjuster. Proficiency in MS Office and Xactimate software is required....Risk
- Job Summary The Risk Adjustment coder will identify, collect, assess, monitor and document claims and encounter coding information as it pertains to Clinical Condition Categories. Verify and ensure the accuracy, completeness, specificity, and appropriateness of diagnosis...RiskWork at officeFlexible hoursWeekend work
$20 per hour
...A healthcare technology firm based in the United States is seeking a Risk Adjustment Analyst to enhance AI models by evaluating their logic and performance. The ideal candidate will be an expert in healthcare with a strong background in areas like Revenue Cycle Management...RiskHourly payFor contractorsRemote work- Registered Nurse (RN) Risk Manager The Pearl at Fort Lauderdale Rehabilitation & Nursing Center is seeking a qualified RN Risk Manager... ...a level necessary to accomplish this position. Must be able to adjust to a flexible schedule to include evenings, nights and weekend...RiskFlexible hoursNight shiftAfternoon shift
$70k - $90k
...global clients to solve their most complex risk management challenges, delivering... ...of hands‑on claims experience, you will lead thorough investigations, guide claim strategy... ...responsiveness. This is a full life‑cycle WC adjuster position within a TPA environment, and...RiskWork at officeRemote work$87.5k - $90k
Overview Position Title: Professional Liability Adjusting Specialist Location: Maitland, FL (... ...clients to solve their most complex risk management challenges, delivering measurable... ...ourselves. We look for team members who: Lead with transparency We build trust by being...RiskWork at officeLocal area$50k - $60k
...estimating experience highly desired Adjuster experience highly desired, but... ...with on-going projects for marketing purposes. Monitor/control... ...current clients. Actively leads internal team(s) that focuses... ...and solve problems to minimize risk. Why Should You Apply? Competitive...RiskContract workFor contractorsFor subcontractor- ...Project Manager* Develop and manage the project scope, timelines, risks, and quality management across the entire project lifecycle.*... ...manner.* Maintain monthly forecast submissions, including adjustments to resource allocations and vendor payment schedules.* Conduct...Risk
- ...Support Services. Reporting to the Director of Risk Management, the Workers’ Compensation... ...is an exempt position.RESPONSIBILITIES:Lead the Seminole Gaming, Hard Rock International... ...• Consult with attorneys, insurance adjusters and insurance carriers on claims strategy...RiskWork at officeFlexible hoursAfternoon shift
- ...Storage accounts. Key Responsibilities Plans, leads, and manages complex projects within the... ...as planning, scheduling, and budget and risk assessment. Manages a specific project or... ..., schedule and performance. Monitors, adjusts, and reports on the project’s performance...RiskContract workFor contractorsInterim role
- ...A fintech company is seeking a remote Underwriting & Compliance Specialist to evaluate merchant applications. This role focuses on risk management and compliance to ensure merchants meet standards before platform onboarding. Candidates should have 2-5 years of experience...RiskRemote work
$80k - $120k
...project costs using appropriate verification techniques. Balance risk management and cost optimization to minimize potential risks... ...specifications and approved submittals. Meet budgetary objectives and make adjustments to project constraints based on financial analysis. Develop...RiskImmediate start$68.7k - $114.31k
...field offices and increasing the market share of business by providing... ...roles (I, II, III, Senior, Lead, etc.) new hires may be slotted... ...the salary range and these adjustments would be clarified during the... ...CorVel Careers | Opportunities in Risk Management. In general, our...RiskMinimum wageFull timeContract workWork at officeLocal areaImmediate startRemote workFlexible hours$72k
...disciplines, addresses complaints and resolves problems. Provides risk management training for all new employees at all residential... ...that all licensing, accreditation, contracts, rate agreements, Medicaid applications, and other standards for programs and services are...RiskFull timeTemporary workRemote work- ...Lending Manager is responsible for leading the credit union's consumer... ...satisfaction and target goals. Portfolio & Risk Management Manage performance of... ...strategic objectives. Analyze market trends and member needs, making adjustments and recommendations to keep the program...RiskContract work
- A healthcare facility in New York is seeking a Clinical Risk Manager. The role involves assisting the Hospital Risk Manager in developing and implementing risk management processes, coordinating with regulatory bodies, and developing compliance action plans. Candidates...Risk
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