Risk Adjustment Predictive Analytics Pro
Molina Healthcare of Illinois
Molina Healthcare in Kentucky is seeking an analytics professional to support enterprise risk adjustment predictive analytics. You will design and develop systems to support proactive interventions and retrospective reviews. The role emphasizes SQL, T-SQL, SSIS/SSRS, Power BI, and cloud platforms, with a focus on QA reporting for Medicaid, Marketplace, and MMP lines. Ideal candidates bring strong data modeling skills and the ability to translate insights into business actions. #J-18808-Ljbffr Molina Healthcare
$160k - $180k
...the Role: You'll join our centralized Risk, Analytics & Data Science team as a Manager, to serve... ...to pursue, which premiums to adjust, which programs to renegotiate — and drive... ...years of experience in actuarial pricing, predictive modeling, or other Risk Analytics related...RiskFlexible hours- Optum in New York, NY seeks an Executive Director of Risk Adjustment to lead enterprise risk adjustment programs across Optum East and embed... ..., partnering with clinical leadership, coding teams, and analytics to drive sustainable risk capture, quality, and financial performance...Risk
- UASI is seeking a Risk Adjustment Clinical Documentation Specialist to support coding accuracy and HCC capture in a fully remote capacity. The role emphasizes clinical judgment, analytical skills, and a commitment to documentation integrity reflecting patient severity...RiskRemote job
- ...Division has been helping farmers manage risk since 1915 and is one of the few private... ...based on seasonal needs. As a Crop Adjuster, You Will Understand and work claims for... ...Overhead reaching and grabbing. Regular and predictable attendance. Ability to conduct visual inspections...RiskFull timePart timeSeasonal work
$22 - $33 per hour
...documentation to identify and validate diagnosis information used in risk adjustment coding. Applies established coding guidelines, payer... ...health record systems Strong attention to detail and analytical skills Ability to work within established procedures and prioritize...Risk$143.62k - $229.79k
...Overview As a Consulting Actuary - ACA Risk Adjustment, you will play a pivotal role in delivering a wide array of actuarial and analytical services for our organization. Responsibilities include leading pricing strategies and actuarial initiatives for business segments...Risk$134.6k - $230.8k
Optum NY, is seeking an Executive Director of Risk Adjustment join our team in New York, NY. Optum is a clinician-led care organization that... ...escalation point for risk-related regulatory matters Data, Analytics & Reporting Drive actionable reporting on RAF performance,...RiskMinimum wageFull timeWork experience placementLocal areaWork from home$6,741 per month
...Medical Economics (Trend Analytics, SQL, Power BI,... ...healthcare data to identify risks, opportunities, and... ...health care analytics and predictive modeling, and... ...enterprise. Performs pro forma sensitivity analyses... ...principles such as risk adjustment, capitation, FFS (Fee-...RiskWork experience placementWork at officeRemote work$114.7k - $135k
OverviewThe Analytics Lead will play a critical role in driving data-informed decision making... ...efficiency, underwriting performance, risk management, and customer outcomes.... ...advanced analytics initiatives including predictive modeling, segmentation, trend analysis,...RiskFull timeWork at officeFlexible hours- ...service offerings, we’re looking for experienced and motivated Risk Adjustment Clinical Documentation Specialist professionals to join our... ...integrity. This role requires strong clinical judgment, analytical skills, and a commitment to advancing documentation excellence...RiskRemote work
- UnitedHealth Group's Optum NY in New York, NY seeks an Executive Director of Risk Adjustment to lead enterprise-wide risk capture programs across networks, ensuring compliant and sustainable RAF performance that affects financial results. The role partners with provider...Risk
$223k - $335k
...Intelligence is a team within FINRA's Risk & Intelligence organization... ...identifying, analyzing, and predicting a broad and complex range of... ...success in applying rigorous analytical and strategic thinking skills... ...required by law (all pro-rated in the first year). Additionally...RiskFull timeTemporary workFor contractorsFor subcontractorWork at officeLocal areaImmediate start- Role Details Job Title: Property Claims Adjuster Location: Remote / Hybrid (dependent upon... ...us insure it Tokio Marine HCC - Public Risk Group, a member of the Tokio Marine group... ...and verbal communication skills. Strong analytical, organizational, and investigative...RiskFull timeWork at officeLocal areaRemote work
$160k - $185k
...around the world. Senior Quantitative Analyst, Quantitative & Risk Analytics The Quantitative and Risk Analytics group is hiring a Senior... ...regulation. If you believe that you need an accommodation or adjustment, due to a medical condition or disability, to search for or apply...RiskLocal areaFlexible hours3 days per week$120k - $150k
...we help customers to manage risk. Join us as a AssociateActuary... ...potential to help improve how we predict, manage and mitigate risk.How... ...implementing best practices analytical techniques, catastrophe... ...team to ensure adequate risk-adjusted returns contemplating expected...RiskFull timeWork at office- ...Portfolio Management org. You will drive strategy, build and validate models, and develop next-gen analytical tools across large data environments to mitigate credit risk. The role emphasizes leadership, cross-functional collaboration, and delivering scalable analytics...Risk
- LucyRx in the United States seeks a Manager of PBM Underwriting & Analytics to lead underwriting & analytics teams, shaping pricing... ...programs. The role requires deep PBM knowledge, data analysis, and risk management, with collaboration across finance, operations, and...Risk
- ....Job Summary:As a Business Control Manager in the Chief Data & Analytics Office’s (CDAO) Data Privacy Governance team, as a Vice President... ...and continuously improving the control environment (processes, risks, controls) related to the Data Privacy Initiatives. The...RiskWork at office
$150k - $180k
...internally and for clients. Pricing & Predictive Modeling Knowledgeable on... ...strategies using predictive analytics, actuarial techniques, and... ...pricing models to improve risk segmentation, profitability,... ...data. The salary may also be adjusted based on applicant’s geographic...RiskFull timeTemporary workPart timeLocal area- ...VA is seeking a Senior Business Analyst to join the Card Credit Risk Management team focused on loss forecasting and allowance. You... ...and financial reporting. The role requires at least 2 years of analytical experience and a quantitative degree. Proficiency in SQL and strong...Risk
- Florida Blue Group is seeking a Senior Actuary to lead Medicare pricing and risk revenue analytics. The role involves supporting pricing, trend analytics, gross margin reporting, and financial reporting across ACA, Medicare, Group, and reserves, with rotations through...RiskRemote job
- McGriff, a division of Marsh McLennan Agency, is seeking a Senior Risk Analyst in the Transportation & Logistics Practice. You will... ...extract data from raw files to populate datasets and create complex analytic reports for service teams and clients. You will identify...Risk
- GuideWell is seeking an experienced actuary to lead Medicare pricing and risk revenue analytics, driving insights across ACA, Medicare and group lines. You will mentor actuaries and participate in rotations within cross-functional teams, influencing pricing and strategic...RiskRemote job
- Guy Carpenter, a Marsh company, seeks an experienced Reinsurance Actuary to join the Global Analytics team. You will build analyses evaluating assumptions, premiums, and risk, and consult with clients on actuarial services to mitigate risk. You will blend GC, client, and...RiskWork at office
$114.4k - $216.32k
...planning, space utilization, and analytics strategies that support... ...institution. Maintain regular and predictable attendance. Consistently... ...depth perception, and ability to adjust focus. The work environment... ...toxic or caustic chemicals; risk of electrical shock; and...RiskLocal area$70k - $85k
Risk Adjustment Coding Specialist II (CST/EST) Department: Quality - Risk Adjustment Employment Type: Full Time Location: 1600 Corporate Center Dr., Monterey Park, CA 91754 Reporting To: Liz Francisco Compensation: $70,000 - $85,000 / year Description We are currently seeking...RiskFull timeWork at officeRemote workHome office- ...on delivering long-term, tax-efficient, risk-adjusted returns through diversified real estate... ...insights. This is MLG’s first-ever Analytics Engineer hire, supporting the modernization... ...for current BI reporting, future AI & predictive analytics, and enterprise data...RiskWork at officeFlexible hoursShift work
- ...Description Job Description Tiger Analytics is an advanced analytics... ...governance, and delivery predictability. This role ensures projects... ...teams. Track milestones, risks, and dependencies with clear... ...through continuous adjustments. Requirements Program...RiskLocal area
$33.88 - $42.35 per hour
...based coding information as it pertains to CMS Hierarchical Condition Categories (HCC). Participates in and supports the Medicare Risk Adjustment team-based environment to educate providers on coding compliance and consistency. Supports the creation, maintenance, and...RiskContract workWork experience placementFlexible hours- Guidehouse in Arlington, VA is seeking a Risk & Regulatory Compliance Data Analyst to support fraud operations by maintaining daily... ...process improvements. A Bachelor's degree and 3+ years in data analytics or consulting are required, with ability to obtain Public Trust...Risk
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