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$110 per hour
...Risk-adjustment / HCC coding leader is a remote review track for evaluating AI outputs across risk adjustment / hcc coding leader specialist operations workflows. Reviewers grade workflow correctness, policy adherence, and stakeholder fit; flag operational risk; and document...SuggestedRemote jobFor contractorsWork experience placement10 hours per week- ...HR Recruiter and Office Coordinator At WorldTrips, a proud member of the Tokio Marine HCC group of companies, we believe in more than just business-we believe in empowering our people. As a global leader in specialty travel medical and trip protection insurance...SuggestedFull timeWork at officeLocal areaRemote workWork from home
Tokio Marine Hcc
Remote20 hours ago - ...members. Arrive on time for work, attend work regularly, and successfully complete the responsibilities of the position. Comply with HCC policies, procedures, and practices. Serve actively on campus committees. Secondary - ~ Perform other responsibilities...SuggestedHourly payFull timeContract workWork experience placementWork at office
Hutchinson Community College
Remote20 hours ago $128k - $150k
..., HL7/FHIR formats, and clinical data standardization. Value-Based Care (VBC): Patient attribution/roster files, risk adjustment (HCC scores), quality measures (HEDIS, eCQMs), and shared savings models. Experience with cloud file storage (GCS/S3), SFTP workflows,...SuggestedFull timeWork at officeLocal areaRemote workWork from homeHome office- ...patient engagement. Support quality improvement initiatives through accurate and timely clinical documentation. Contribute to HCC coding, risk adjustment, STAR, HEDIS, and quality-gap closure initiatives . Participate in the development of clinical best...SuggestedWork at officeRemote work
$20 - $25.45 per hour
...and procedures. Follows procedures mandated by government and other payers for completion of coded data including APC assignments and HCC codes. Facility Specific: Responsible for coding ED, Diagnostic, and Ancillary records. Professional Fee: Responsible for...SuggestedFull timeCasual workRemote workWork from homeShift work- ...in accordance with company policies. Stay current with AAPC, AHIMA, CMS, and OIG guidelines, as well as payer policy changes and HCC model updates. Uphold all HIPAA, privacy, and compliance standards in handling patient data and audit documentation, You’ll Love...SuggestedFull timeRemote work
Sprinter Health
Remotea month ago $140k - $170k
...development or close collaboration with data engineers on pipeline design ~ Exposure to value-based care arrangements or risk adjustment ( HCC coding , RADV ) ~ Prior experience at a health plan, payment integrity vendor, or healthcare analytics firm What We Offer...SuggestedDaily paidFull timeFlexible hoursMachinify
Remotea month ago- ...miles of a major airport and willing to travel, as needed (25-60% of time) Preferred Qualifications: ~ Direct experience selling HCC capture or risk adjustment technology to large medical groups, MSOs, or health plans Location | Work Authorization We have a...SuggestedFull timeWork at officeLocal areaHome officeRelocation package3 days per week
Regard
Remotea month ago - ...business development professionals across the United States. Key Responsibilities: Source candidates for Hospice Care Consultant (HCC) positions across the United States. Identify professionals with backgrounds in healthcare sales, business development, account...SuggestedContract workFor contractorsRemote workMonday to Friday
Rehire Solutions
Remotea month ago - ...Risk Assessment & Medicare Analytics Develop and maintain sophisticated risk-adjusted provider group performance models using CMS-HCC methodology . Analyze VBC performance under various CMS and CMMI total cost-of-care models. Monitor and forecast financial...SuggestedFull timeTemporary workWork at officeRemote workVisa sponsorshipFlexible hours
Ennoblecare
Remote25 days ago - ...performed in compliance with HIPAA privacy and security rules. Skills: Proficiency in ICD-10-CM coding with strong understanding of HCC risk adjustment Attention to detail and accuracy in retrospective chart reviews Familiarity with CMS coding guidelines and...SuggestedRemote jobWork at office
- ...setting where explainability and fairness were requirements. Anomaly detection, peer-group construction and case-mix methods (e.g., HCC); AWS and/or Snowflake, including Snowpark or model lifecycle tooling. Healthcare FWA or program integrity datamining in multi-...SuggestedRemote jobLocal areaShift work
- ...alignment with business priorities. Promote the effective use of business tools and company processes. Ensure compliance with HCC procedures and company guidelines. Identify performance gaps or business risks and define corrective action plans where needed....SuggestedRemote job
$140k - $170k
...development or close collaboration with data engineers on pipeline design ~ Exposure to value-based care arrangements or risk adjustment ( HCC coding , RADV ) ~ Prior experience at a health plan, payment integrity vendor, or healthcare analytics firm What We Offer...SuggestedDaily paidFull timeFlexible hoursMachinify
Remotea month ago- ...Medicaid, and provider value-based contracts. This role builds member-level actuarial models that quantify risk adjustment performance, HCC (Hierarchical Condition Category) capture, medical economics, utilization, and population health trends, and translates those models...Remote jobFull timeContract workLocal area
$110k
...within the Liver/Hepatology Medical Oncology community. Manage specific assigned geographic areas and successfully drive the FUJIFILM HCC Risk Biomarkers sales through that community. As assigned interface with Senior Management teams from major IVD manufacturers....Full timeWork at officeLocal areaRemote workFlexible hoursNight shift$35 - $38 per hour
...record documentation. Reviewing medical record information to identify complete and accurate diagnosis code capture based on CMS HCC categories. Maintaining knowledge of relevant regulatory mandates and ensuring activities comply with requirements. Contributing...Full timeContract workRemote work- ...across prospective and retrospective risk adjustment workflows. ~Building scalable capabilities supporting Medicare Advantage (CMS-HCC), ACA Marketplace (HHS-HCC), and Medicaid risk adjustment models. ~Driving enhancements inside careflow™ that improve clinician...Full timeTemporary workFlexible hours
Matrix Medical Network
Remote13 days ago - ...~Track record of sizing new markets or capabilities and getting an investment approved, not just producing analysis ~Fluent in HCC/RAF, HEDIS/Stars, ACO economics (MSSP/ACO REACH/LEAD), payer-provider data workflows ~Comfortable operating with incomplete data under...Full timeTemporary work
Vatica Health
Remote14 days ago - ...product P & L and growth projections to leadership. ~Serve as the subject matter expert in outpatient CDI workflows, risk adjustment, HCC capture, and coding compliance. ~Product Development & Execution ~Translate business requirements into product features, user...Full timeFlexible hours
SOLVENTUM
Remote22 days ago $172.36k - $258.55k
...confounding, selection bias, regression-to-mean, and contamination. ~Appropriate risk adjustment and segmentation (clinical risk, RAF/HCC, social risk proxies where permitted). ~“Desired but Not Required” Advanced Economic / Statistical Analyses ~When...Full timeRemote workAlignment Health
Remote20 days ago- ...business development professionals across the United States. Key Responsibilities: Source candidates for Hospice Care Consultant (HCC) positions across the United States. Identify professionals with backgrounds in healthcare sales, business development, account...Temporary workFor contractorsRemote workMonday to Friday
Rehire Solutions
Remotea month ago - ...in accordance with company policies. Stay current with AAPC, AHIMA, CMS, and OIG guidelines, as well as payer policy changes and HCC model updates. Uphold all HIPAA, privacy, and compliance standards in handling patient data and audit documentation, You’ll Love...Full timeRemote work
Sprinter Health
Remotea month ago - ...program. ~An opportunity to do meaningful work and love what you do. Company Description ProAg, a member of the Tokio Marine HCC group of companies, is positioned as a financially strong and well-capitalized insurer with an AM Best rating of A++. With 100 years...Full time
ProAg
Remotea month ago - ...platforms. ~Excellent written and verbal communication skills. Requirements ~Subject matter expertise spanning population health, HCC/risk adjustment, value-based care models, and quality measurement programs including HEDIS, PQA, Stars, MSSP, and MIPS. ~...Full timeRemote work
Ursa Health
Remotemore than 2 months ago - ...member-month analytic grain. ~Support value-based care program analytics across MSSP, Medicare Advantage Stars, HEDIS, eCQMs, CQL, and HCC risk adjustment on CMS-HCC V28. ~Maintain disciplined engineering practices including version control, peer review, documented...Temporary workRemote work
Quoris, LLC
Remotea month ago - ...Medicaid, and provider value-based contracts. This role builds member-level actuarial models that quantify risk adjustment performance, HCC (Hierarchical Condition Category) capture, medical economics, utilization, and population health trends, and translates those models...Full timeContract work
Reveleer
Remotea month ago $250k - $280k
...measurable production gains. ~Experience with healthcare data (claims, electronic health records, or clinical coding such as ICD, CPT, or HCC). ~Background designing ML systems in regulated, auditable, or high-stakes domains (healthcare, finance, or fraud, waste, and...Full timeCotiviti
Remotemore than 2 months ago$100k - $231.54k
...business results. Preferred Qualifications ~Demonstrated knowledge of Medicare, Medicaid, or ACA risk adjustment methodologies, HCC models, healthcare claims and clinical data, and CMS regulatory requirements. ~Experience at a health plan or provider system....Hourly payFull timeTemporary workWork experience placementCVS Health
Remotea month ago
