Hybrid Quality & Risk Advisor - HEDIS/Risk Expert
Clever Care Health Plan
Clever Care Health Plan in Huntington Beach, CA is seeking a Quality/Risk Advisor to manage relationships with MSOs/IPAs and provider partners while supporting HEDIS/Stars, CAHPS, and risk adjustment KPIs. This full-time role offers a hybrid schedule with three days onsite at the Huntington Beach office and requires strong data reconciliation, education, and collaborative cross-functional work. #J-18808-Ljbffr Clever Care Health Plan
- ...Senior Manager to lead Medicare Advantage RAF, Stars, HEDIS, and CAHPS operations, improving quality, coding accuracy, and member experience. You will oversee... ...while aligning with organizational priorities in a hybrid Huntington Beach setting. #J-18808-Ljbffr PaycomHEDIS
- ...years of experience in litigation and familiarity with legal software, preferably in the healthcare sector. The position requires a hybrid work schedule. Join us to impact our growth while maintaining confidentiality and superior organizational standards. #J-18808-...Suggested
$127k - $160k
...Salary This position operates on a hybrid work schedule. This position will require... .... Job Summary The Senior Manager, Risk Adjustment Operations and... ...Advantage Risk Adjustment (RAF), Stars, HEDIS, and CAHPS initiatives to improve quality outcomes, coding accuracy, member experience...HEDISFull timeWork at officeRemote work- ...Newport Beach, CA, Omaha, NE or Charlotte, NC. This role follows a hybrid schedule of four days in the office (on-site). If you are not... ...giving management early line-of-sight into emerging opportunities or risks.Oversee renewal rate analysis, drawing insights to inform rate-...SuggestedFull timeWork at officeRelocation packageFlexible hours
$152.37k - $186.23k
...Newport Beach, CA, Omaha, NE, or Charlotte, NC.** This role is hybrid with four office days per week. If you are not currently located... ...back‐office function, but as a **strategic lever** used to manage risk, support growth, and enable business decisions. This opportunity...SuggestedWork at officeRelocation packageFlexible hours$152.37k - $186.23k
...comprehensive relocation assistance. This role is hybrid. We believe in empowering our employees... ...Pricing and Product Development, Risk Management, Modeling and Sales within the... ...and risk management developments.* Provide expert-level analysis and insights, including...Work at officeWork from homeRelocation packageFlexible hours1 day per week$152.37k - $186.23k
...Beach, CA, Omaha, NE or Charlotte, NC.** This role follows a **hybrid schedule of four days in the office (on-site)**. If you are not... ...portfolio evolution from renewal rate decisions* Develop current market risk insights with regards to product portfolio with emphasis on...Work at officeRelocation packageFlexible hours- ...Newport Beach, CA; Omaha, NE; or Charlotte, NC**. This role follows a hybrid schedule of four days in the office (on-site). If you are not... .... **How you’ll help move us forward:*** Balance product profit, risk, and market competitiveness; help develop and test creative...Work at officeImmediate startRelocation packageFlexible hours
- ...support exceptional service delivery, regulatory compliance, quality outcomes, positive member and provider experiences, and... ...outcomes and plan performance. Lead operational support for Risk Adjustment, HEDIS, CAHPS, Medicare Part C and Part D requirements, and annual...HEDISWork at officeImmediate start
$123 - $133 per hour
...out of Newport. The ideal candidate will live and be able to work hybrid at our Newport Beach, CA office.Summary:The Accounting Manager... ...reconciling items, and effective management of financial and operational risk.This role provides day-to-day leadership and oversight of the...Work at office$105.12k - $128.48k
...Pacific Life in Newport‑Beach, CA or Omaha, NE. The program follows a hybrid schedule of four on‑site days per week. If you are not located... ...Rotation Program Perform analyses to assess and manage risk associated with insurance and financial products and instruments...Relocation package$215k - $355k
...Wells Fargo is seeking a Senior Lead Credit Risk & Approval Officer in our Commercial Real... ...risk management to protect portfolio quality while supporting business growth across the... ....Job Expectations:This position offers a hybrid work schedule.Willingness to work onsite...Full timeWork experience placementLocal area$101.2k - $140.76k
...Healthcare Process Risk Senior Associate As a Healthcare Process Risk Senior Associate, you will get the opportunity to grow and... ...compensation decisions are dependent upon the facts and circumstances of each position and candidate. #Hybrid #LI-LG1 Grant Thornton LLPWork at office- O’Melveny & Myers LLP in Newport Beach is seeking a Conflicts Analyst to support our New Business and Lateral New Hire processes. You will identify, review, analyze, and resolve ethical and business-related conflicts of interest. The role requires collaboration with attorneys...
$203.76k - $249.04k
...comprehensive relocation assistance. This role is hybrid. We believe in empowering our employees... ...Pricing and Product Development, Risk Management, Modeling and Sales within the... ..., execute project plan with on time high quality deliveries. Stay current with all regulatory...Work at officeWork from homeRelocation packageFlexible hoursShift work1 day per week$80k - $105k
...Personal Risk Specialist The Personal Risk Specialist is an outside sales position focused on serving the unique insurance needs... ...production staff. Establish a relationship as a trusted partner and advisor to clients and prospects. Develop and support cross-selling...Temporary workWork at officeLocal areaFlexible hoursAfternoon shift- ...Senior Program Manager (Hybrid) Position Type: Contract (08-18-2025 - 01-31-2026) Location... ...governance metadata management and data quality frameworks. Excellent communication... .../ Proposal Management, Project Planning, Risk/Crisis Management, Project Governance,...Contract work
$82.6k - $162.8k
Position Summary Cyber Security & Risk Strategy Consultant Our Deloitte Cyber team understands the unique challenges and opportunities... ...verbal communication skillsMeticulous attention to detail and quality of work productAbility to build and sustain professional...Local areaVisa sponsorship$115k - $130k
...Momentum Recovery Facility, we leverage advanced technology to deliver quality mental health services tailored to the needs of our clients. Our... ...support to a diverse population, including individuals at risk of suicide and adults facing various mental health challenges....Remote jobFull timeWork at officeMonday to Friday- ...The role requires 3-5 years of P&C claims experience, strong communication, and the ability to multitask and work independently. Local travel may be required; hybrid in-office schedule 2x/week in LA or Newport Beach. #J-18808-Ljbffr EPIC Insurance Brokers & ConsultantsWork at officeLocal area
- ...improvements. You will prepare reconciliations, journal entries, and divisional financial statements, while partnering across entities. CPA preferred; Bachelor’s in Accounting or Finance; 3-5 years’ experience needed; hybrid remote options available. #J-18808-Ljbffr UltiproRemote job
- ...retrieval; medical record review and coding; and in-home health assessments. Together these support health plans across risk adjustment, HEDIS, quality reporting, and member care — with a substantial delivery organization in Ahmedabad, India supporting the U.S. operation...HEDISTemporary workRemote workWork from home
$73.5k - $147k
...California locations: San Francisco, Irvine, and Los Angeles. This is a hybrid role that has a requirement of working at least three days a... ...your well-being. Marsh (NYSE: MRSH) is a global leader in risk, reinsurance and capital, people and investments, and management...Minimum wageWork experience placementWork at officeLocal areaRemote workFlexible hours3 days per week1 day per week- ...productivity, staffing, patient experience, financial performance, quality, risk adjustment, care gap closure, utilization, and total cost of... ...Visits, HCC documentation and chronic-condition reassessment, HEDIS/Stars care gap closure, preventive screenings, medication...HEDISLocal areaFlexible hours
- ...innovating our business and creating a superior customer experience. We’re actively seeking a talented Director of Product and Pricing Risk to join the Workforce Benefits Product and Pricing organization.We are actively seeking a talented Actuary & Director, Product...Full timeTemporary workWork from homeRelocation packageFlexible hours1 day per week
$203.76k - $249.04k
...Description: Pacific Life is seeking an Actuary & Director, Model Risk Management to join our team. This role is on-site 4 days per... ...risk and driving for meaningful improvements. Provide expert guidance on efficient modeling techniques and robust governance...Work from homeRelocation packageFlexible hours1 day per week$167.67k - $204.24k
...model development projects and serve as the modeling Subject Matter Expert for new and existing life and annuity products. Apply... ...implementation through model deployment. Support and comply with Model Risk Management initiatives, documentation, and standards....Work at officeWork from homeRelocation packageFlexible hours1 day per week- ...maintain an atmosphere of open and positive communication, professionalism ad creativity at all times. Train and Educate Beauty Advisors within all retailers (Sephora, Ulta, Nordstrom, Bloomingdales, Blue Mercury) Operations: Ensure the counter/gondola is...Hourly payFreelance
- ...responsible for the strategic oversight, development, and execution of Quality Improvement and Risk Adjustment programs within a managed care environment. This role ensures optimal performance in HEDIS, STAR ratings, and Burden of Illness (BOI) accuracy by integrating...HEDISFlexible hours
$100k - $150k
...Risk Advisor Why join M&G: We continue to win awards and achieve honors for our culture, industry expertise, and services: ~ Central... ...oriented You drive towards results without sacrificing quality You excel in reaching goals while remaining accountable to...Work experience placementWork at officeRemote workFlexible hours2 days per week3 days per week
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