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- ...Massadvantage in Worcester, MA is seeking a Manager of Risk Management to oversee Medicare risk adjustment activities. This role involves driving strategies, ensuring compliance, and interacting with vendors and providers. Ideal candidates will have at least 7 years in...Risk
Massadvantage
Worcester, MA4 days ago - ...Leading the enterprise risk adjustment strategy, the full-time Director of Risk Adjustment will provide strategic direction and operational oversight to ensure accurate and compliant capture of member risk data while collaborating with various business leaders in a remote...RiskFull timeRemote work
Virtual Vocations Inc
United States1 day ago - ...Risk Adjustment ManagerCoxHealth is a leading healthcare system serving 25 counties across southwest Missouri and northern Arkansas. The organization includes six hospitals, 5 ERs, and over 80 clinics. CoxHealth has earned the following honors for workplace excellence:...Risk
CoxHealth
Springfield, MO3 days ago $87.7k - $157.8k
...Position Purpose: Manage the business processes related to risk adjustment and quality improvement across Centene’s for assigned products and plans. Key Details: Remote role with preference in AZ location with occasional travel Develop and implement action plans...RiskFull timePart timeWork at officeLocal areaRemote workFlexible hours$70.1k - $126.2k
...Position Purpose: With the Carolina Complete Health Plan Risk Adjustment team, you will plan, organize, monitor, and oversee risk adjustment projects along with tracking monthly goals, assigning project tasks to Risk Adjustment Coordinators, outreach to Providers for...RiskFull timePart timeRemote workFlexible hours- CVS Health is seeking a Lead Director of Informatics (Performance Reporting & Insights) to drive enterprise risk adjustment analytics and BI solutions. You will transform clinical, operational, and claims data into actionable insights that guide provider performance and...Risk
- ...and drives sustainable workflow improvements that strengthen documentation accuracy, coding compliance, provider experience, and risk adjustment performance. Job Description Essential Duties and Responsibilities Lead, coach, and manage the coding team,...RiskContract workWork at officeLocal areaRemote work
$31.03 - $36.03 per hour
...s degree, an additional 2 years of relevant work experience is required in addition to the required work experience.3 years of risk adjustment and/or hierarchical condition category coding experience.Strong knowledge of diagnosis code validation, coding guidelines, and...RiskTemporary workWork experience placementRemote workCynet Systems
United States3 days ago- ...Health is seeking a Regional Director of Burden of Illness Operations to lead BOI initiatives across physician practices, guiding risk adjustment programs and documentation improvement. You will translate CMS-HCC methodologies into scalable workflows, collaborating with...Risk
- Astrana Health, Inc. is seeking a Sr. Director - Risk Adjustment to lead the Risk Adjustment organization from our Alhambra office. You will build structure, standardize processes, develop leaders, and drive accountability across a multi-market operation. The role requires...RiskWork at office
$147.55k - $215.18k
...Hi, we're Oscar. We're hiring a Senior Manager, Actuarial - Risk Adjustment to join our Actuarial team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to...RiskFull timeRemote workWork from homeHome office$102.7k - $164.6k
...Highmark Inc. Job Description : JOB SUMMARY This job provides end-to-end management, delivery and support to new and existing Risk Adjustment Programs. The incumbent will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government...RiskFull timeFor contractorsWork at officeLocal area$196.73k - $286.9k
...Hi, we're Oscar. We're hiring a Senior Director, Actuarial - Risk Adjustment to join our Actuarial team. Oscar is the first health insurance company built around a full stack technology platform and a relentless focus on serving our members. We started Oscar in 2012 to...RiskFull timeRemote workWork from homeHome office- Vytwo in Dallas, TX seeks a Risk Adjustment Coding Auditor for a 6-month engagement to support CMS RADV audit passes. The role requires a CPC and CRC certification and 5+ years of risk adjustment experience, with proficiency in MS Office. The team will run first and second...Risk
- ...Employment Type: Full time Shift: Day Shift Description: We are looking for a full-time risk adjustment coding specialist to join our growing Population Health team. This is a full-time, fully remote position on a day shift schedule, including training. The...RiskFull timeLocal areaRemote workShift workDay shift
- ...message and complete the application in full. Below, you’ll find other important information about this position. The Director of Risk Adjustment leads Peak Health's enterprise risk adjustment strategy and operations across all applicable lines of business. This role...RiskFull timeShift work
- Humana is seeking a Remote Risk Adjustment Coding Analyst to provide analytical and operational support across programs. You will analyze data, prepare executive-ready summaries, and develop dashboards to monitor performance and compliance. This role emphasizes turning...RiskRemote job
- Mount Sinai Medical Center of Florida, Inc. is seeking a Certified Risk Adjustment Coder to ensure accurate coding and documentation standards. The role involves reviewing medical records, providing feedback to physicians, and maintaining coding credentials. The ideal candidate...Risk
$143.62k - $229.79k
...Consulting Actuary -ACA Risk Adjustment 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...RiskRemote workBlue Cross and Blue Shield of North Carolina
United States3 days ago- Astrana Health Management is seeking a Risk Adjustment Coding Specialist II to support our Northern California market. The role involves extensive chart reviews, coding accuracy audits, and education for providers. Travel to provider offices is required up to 50-75% of...Risk
- ...ready to make a difference join us. The Impact Youll Have Blue Cross and Blue Shield of Minnesota is hiring a Program Manager Risk Adjustment Coding and this position youll be responsible for the design implementation evaluation and ongoing management of the Risk...RiskFull timeFor contractorsWork at officeRemote work2 days per week
Blue Cross Blue Shield of Minnesota
Eagan, MN26 days ago - ...Risk Adjustment Coding Specialist We are looking for a full-time risk adjustment coding specialist to join our growing Population Health team. This is a full-time, fully remote position on a day shift schedule, including training. The Risk Adjustment Coding Specialist...RiskRemote jobFull timeDay shift
- Insight Global is seeking Medical Coders specializing in Risk Adjustment Coding for a leading healthcare client. These professionals will review medical records and clinical documentation to accurately assign ICD-10-CM diagnosis codes that support risk adjustment and HCC...RiskRemote job
- Altais is seeking a Senior Coding Analyst, Risk Adjustment to code medical records for HCC reimbursement, support audits, and improve clinical documentation. You will collaborate with physicians and internal stakeholders to ensure accurate coding and compliance across programs...RiskFlexible hours
- Horizon Blue Cross Blue Shield of New Jersey is seeking a Manager of Risk Adjustment Vendor & Performance Management to lead vendor strategy and performance analytics for Enterprise Risk Adjustment in Newark, with remote work options. The role drives KPI design, contract...RiskContract workRemote work
- Gallagher Bassett is a leading risk and claims management company now hiring a Claims Adjuster. The role focuses on General Liability Bodily Injury, Premises, and Litigation Management with extensive interaction among clients, claimants, and internal teams. A strong emphasis...RiskRemote jobImmediate start
$100k - $231.54k
...is seeking a Lead Director, Informatics (Performance Reporting & Insights) to lead the development and delivery of enterprise risk adjustment analytics and business intelligence solutions. This role transforms complex clinical, operational, and risk adjustment data into...RiskHourly payFull timeTemporary workWork experience placementLocal area- A.G. Risk Management, Inc. is seeking an experienced Claims Adjuster to join our team. This role involves investigating insurance claims, evaluating coverage, and negotiating fair settlements while coordinating with policyholders and external experts. The ideal candidate...RiskRemote job
- Altais is seeking a Senior Coding Analyst, Risk Adjustment, to code medical records for HCC reimbursement and guide clinical documentation improvement across the Medicare Advantage program. You will support audits, provide analytics, and train provider offices while collaborating...RiskRemote job
- ...Job Description: A prominent insurance organization specializing in claims handling and risk management seeks a highly skilled Senior Claims Adjuster to join its dedicated claims team. This role is ideal for an experienced professional with a strong background in commercial...RiskFull time
The Jacobson Group
Texasa month ago
