Lead, Medicare & ACA Risk Adjustment
Blue Cross Blue Shield of Massachusetts
Blue Cross Blue Shield of Massachusetts is seeking a Manager of Medicare & Commercial Risk Adjustment in Hingham, MA. You will lead a team of certified coders and QA auditors, overseeing MA and ACA risk adjustment coding and medical record reviews for CMS and HHS submissions. The role drives quality, compliance, and process improvements across internal and external partners. You will build provider relationships, deliver ongoing education on risk adjustment, and ensure audit readiness with #J-18808-Ljbffr Blue Cross Blue Shield of Massachusetts
- Blue Cross Blue Shield of Massachusetts, Inc. is seeking a Risk Adjustment Provider Performance Consultant to design and execute provider engagement... ...partner with provider networks, clinic managers, and coding leads to enhance documentation, accuracy of CMS HCC capture, and...Risk
- Blue Cross Blue Shield of Massachusetts is seeking a Risk Adjustment Provider Performance Consultant to design and execute provider engagement... ...Senior Director of Risk Adjustment and Analytics. You will lead cross-functional engagement with provider clinic managers, billing...Risk
$120k - $160k
...Job Description Job Description Lead Superintendent Join the Lee Kennedy Team... ...reflects real-time site conditions. ~ Adjust material and equipment deliveries to meet project milestones. ~ Identify risks, forecast potential challenges, and develop...RiskFor contractorsFor subcontractorFlexible hours$50k
Category/Area of Expertise: Risk Management & Insurance Job Requisition: 538804 Address... ...S. family of brands, which includes five leading omnichannel grocery brands - Food Lion,... ...applications. Basic Qualifications: Licensed adjuster or ability to obtain license (as...RiskFull timeLocal areaRemote workFlexible hours$118.71k - $145.09k
...your true colors to blue. The Role The Risk Adjustment Provider Performance Consultant role is... ...with provider clinic managers, billing leads, and coding supervisors to drive hands-... ...7+ yearsof extensive experience in Medicare Advantage risk adjustment, provider network...RiskFull timeShift work$26.89 - $36.19 per hour
...Medication Dispensing which includes Carousel functionality, inventory adjustments, expiration date tracking and demand picks of floor stock... ..., clean and safe work environment. Minimizes work related risks and reports Safety Issues to Manager of Med Safety Officer. Performs...RiskFull timeWork experience placementMonday to FridayShift workAfternoon shift$120k - $202.5k
...forAn experienced Artificial Intelligence Compliance & Automation Lead who will play a critical role in modernizing and scaling the firm... ...of AI-enabled solutions that improve compliance monitoring, risk identification, evidence collection, reporting, workflow efficiency...RiskFull timeTemporary workFlexible hours- General Description The Lead Teacher oversees the education of each of their children in... ...Provides parents/guardians with initial adjustment report and developmental reports every three... ...of supporting low‑income families and at‑risk children. All South Shore Stars...RiskFull timeWork at officeFlexible hoursShift work
$120k - $202.5k
Lead cross-functional product readiness and delivery activities for strategic AI initiatives across Data & AI. Partner with Product, Engineering... ..., including status reporting, executive communications, risk tracking, and issue escalation.Lead capacity planning, release planning...RiskFull timeTemporary workFlexible hours- State Street is seeking an accomplished technology executive to lead engineering, delivery, and platform transformation for its Collateral... ...and cloud-native platforms, with a focus on platform stability, risk management, and executive #J-18808-Ljbffr State Street...Risk
$116.2k - $229.1k
...design and best practices, and managing risks and stakeholder communications while ensuring... ...professional relationshipsAbility to lead projects or workstreamsAbility to manage... ...The disclosed range estimate has not been adjusted for the applicable geographic differential...RiskLocal area- ...world’s most sophisticated clients using leading technology and exceptional service.... ...Product, Technology, Operations, Finance, Risk, and senior leadership stakeholders.The... ...committed to working with and providing adjustments to individuals with health conditions and...RiskFull timeH1bWorldwideFlexible hours
$102k - $136k
...foundation behind our global benefits programs. Lead the P&C compliance calendar, including... ...Lead benefits-related committees and risk programs, including HIPAA privacy and security... ...requirements related to ERISA, HIPAA, ACA, COBRA, Form 5500 reporting, mental health...Risk$120k - $225k
...solutions, tailored to the unique return and risk objectives of institutional clients in... ...because we believe multiple perspectives lead to more informed investment and business... ...participantsExhibit flexibility and resilience by adjusting focus and responsibilities based on team...RiskFull timeContract workLocal areaRemote workFlexible hours1 day per week$103.45k - $169.96k
As the Organization Readiness Program Lead, you will execute on and support the Group Benefits... ...of initiatives, opportunities and risks.Support the implementation and integration... ...along with active listening skillsAbility to adjust communication style and content to...RiskFull timeWork experience placementH1bWork at officeRemote workVisa sponsorshipWork visaFlexible hours3 days per week$220k - $292k
...-Service (RaaS) AUV operations.ABOUT THE JOBWe are looking for a Lead Mission Systems Software Engineer to join our rapidly growing Maritime... ...using a third-party service provider to conduct pre-employment risk, integrity, and due diligence screening and assessing potential...RiskFull timeWork experience placementWork at officeImmediate startRemote workFlexible hours$169.4k - $279.6k
...way for best-in-class solutions. As a Lead Architect, you will collaborate with senior... ...AI design • Help establish governance, risk, and control processes that ensure safe, compliant... ...transformational change. Able to adjust plans, priorities and strategies in response...RiskTemporary workWork experience placementLocal area- ...Lead Structured Cabling TechnicianThe Lead Structured Cabling Technician is responsible... ...issues.Collaborate with network engineers to adjust AP placement or configuration as needed.... ...Ensure adherence to ICRA (Infection Control Risk Assessment) protocols in relevant...RiskFor contractorsLocal area
$104.04k - $127.16k
...Bring your true colors to blue. The Role The Manager of Medicare & Commercial Risk Adjustment leads a team of certified risk adjustment coders and QA... ...Human Services (HHS) Affordable Care Act Marketplace (ACA) Qualified health plans. This role leads all RA coding...RiskFull timeShift work$110k - $188.75k
...GAO) is looking for a senior Oracle Fusion Financials Functional lead to join our Finance Systems Services (FSS) group. This is a critical... ...globe, institutional investors rely on us to help them manage risk, respond to challenges, and drive performance and profitability....RiskFull timeTemporary workFlexible hours$110k - $181.25k
...Team at State Street is seeking a qualified Client Implementation Lead to support the industry’s first comprehensive front-to-back... ...the globe, institutional investors rely on us to help them manage risk, respond to challenges, and drive performance and profitability....RiskFull timeTemporary workFlexible hours- ...Job Description Job Description Lead Risk Manager, Payment Fraud Toronto Onsite | Full-Time | Hybrid after onboarding | Reports... ...fraud patterns, evaluate model performance, and inform strategy adjustments. • Strategic liaison — Act as the single point of contact...RiskFull timeWork at officeRelocationVisa sponsorship
$110k - $188.75k
...are looking for This role is the Wealth Transaction Monitoring Lead responsible for the continued design and deployment of suspicious... ...and investigative tools designed to mitigate the financial crime risks specific to the Wealth and broker-dealer business. A minimum of...RiskTemporary workWork at officeRemote workWork from homeFlexible hours$141.2k - $278.3k
Position Summary Lead Solution Architect - AI & Engineering/EaasJoin Deloitte’s... ...and delivery leaders to manage priorities, risks, dependencies, and quality throughout the... ...disclosed range estimate has not been adjusted for the applicable geographic differential...RiskLocal areaFlexible hours$142.3k - $195.7k
Become a part of our caring communityThe Lead Solutions & AI Enablement Architect works... ...Compliance: Lead architecture checkpoints and risk reviews; ensure designs conform to... ...a better quality of life for people with Medicare and Medicaid, families, individuals, military...RiskFull timeTemporary workFor contractorsWork at officeRemote workWork from homeHome office- ...Job Description Job Description Summary/Objective : The Lead Superintendent oversees the full scope of the physical construction... ...parties to ensure that all requirements are understood Manage risk prevention requirements of site and Subcontractors by ensuring...RiskContract workFor subcontractorWeekend work
$196k - $269.5k
...looking for a Director, Global Indication Lead, Rheumatology. In this key role, you will... ...developments to inform brand strategy adjustments. Represent argenx at industry conferences... ...options to optimize trade‑offs, balancing risk, and global value considerations. Basic Qualifications...RiskTemporary workWork at office$170k - $190k
...are seeking a commercially minded Vendor Management and Renewals Lead to partner with Sales, Customer Experience, Finance, and Legal to... ...buyers evaluate vendors, negotiate contracts, and manage commercial risk. If you have spent your career on the buy side, this role lets...RiskContract work$22 - $30 per hour
...categories; and stocking, zoning, and cleaning all departments. Leads and participates in teams by using and sharing resources, information... ...: Displays curiosity and a desire to learn; takes calculated risks; and demonstrates courage and resilience. Strive for Excellence:...RiskHourly payMinimum wageFull timeTemporary workPart time$151.2k - $234.4k
...for technical excellence and innovation, lead and develop top talent, pursue strategic... ...complex projects with a focus on quality, risk management, and long‑term value.Foster a... ...accessible to all. If you require reasonable adjustments to be made during the recruitment process...RiskFull timeTemporary workPart timeCasual workLocal areaFlexible hours
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