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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, MA1 day ago $54.3k - $145.86k
Role Description Under the direction of the Senior Manager of the RI Retro Ops Team, the Risk Adjustment Outreach Manager is responsible for leading initiatives that support the organization’s risk adjustment program and ensure timely and accurate data capture. A Brief...RiskFull timeRemote workCVS Health
Remote1 day ago$130k - $150k
Role Description Job Description: Director of Risk Adjustment ~Strategic Client Management: ~Serve as the primary operational partner for multiple external clients across medical groups, health systems, and risk-bearing entities. ~Serve as the trusted advisor and...RiskFull timeWork experience placementIKS Health
Remote1 day ago- ...Blue Cross Blue Shield of Nebraska is seeking a Healthcare Analytics professional to analyze healthcare data for Risk Adjustment programs, evaluate performance, and drive actionable insights for intervention planning and decision‑making. The role supports reporting, forecasts...RiskRemote work
BlueCross BlueShield of Nebraska
Saint Paul, MN1 day ago - ...Manager Risk Adjustment Program At BayCare, we are proud to be one of the largest employers in the Tampa Bay area. Our network consists of 16 community-based hospitals, a long-term acute care facility, home health services, outpatient centers and thousands of physicians...RiskFull timeRemote workShift work
BayCare
United States10 days ago - A leading insurance and risk management firm is seeking a Claims Adjuster in Dallas, Texas. The ideal candidate will have 3-5 years of experience managing lost time/indemnity claims, with an active Texas Adjusters' license. Responsibilities include assessing claims, communicating...RiskRemote work
Arthur J. Gallagher & Co.
Dallas, TX1 day ago - Jobtailor is seeking a Lead Director - Revenue Integrity (Medicaid) in Connecticut to drive Medicaid risk adjustment and revenue integrity initiatives across segments. You will lead strategic programs, manage performance, and use data-driven decisions to ensure accurate...Risk
- ...A leading risk and claims management provider in Miami, FL, is seeking an Adjuster General National. This role involves handling national claims of various complexities, examining policies, and reconciling catastrophic claims. Candidates should possess a bachelor's degree...Risk
Sedgwick Claims Management Services
Doral, FL14 hours ago - Role Description Director, Product Manager - Risk Adjustment (Remote) About the Role: ~Type: Full-Time, Salaried ~Compensation: $152,000-$183,000, 20% bonus ~Location: Fully Remote (must be located in the United States) ~Hours: Full-Time, Days What to...RiskFull timeTemporary workRemote workFlexible hours
Matrix Medical Network
Remote5 days ago - The Alliance seeks a Risk Adjustment Director in California or hybrid. This role involves overseeing risk adjustment functions, managing the team, and providing expert advice on coding methodologies. Ideal candidates are seasoned leaders in managed care with substantial...RiskRemote jobLocal area
- ...A leading risk management firm located in Atlanta seeks a General Liability Adjuster. In this role, you will investigate claims and negotiate settlements while leveraging your six years of general office experience. The ideal candidate will have strong communication skills...RiskWork at office
Sedgwick
Atlanta, GA14 hours ago $31.03 - $36.03 per hour
...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,...RiskTemporary workWork experience placementRemote workCynet Systems
United States3 days ago- ...Integrity (RI), the Lead Director - Revenue Integrity (Medicaid) is responsible for driving segment-level performance across Medicaid risk adjustment and revenue integrity initiatives. Leads strategic program execution, performance management, and data-driven decision-making...RiskWork at office
- ...A healthcare technology company is seeking a Coding Associate responsible for delivering high-quality risk adjustment coding services for clients. This role requires reviewing medical records, assigning diagnosis codes, and ensuring compliance with CMS standards. Required...RiskRemote work
Intus Care
New York, NY4 days ago - A leading healthcare provider in Boston seeks a Manager of Risk Adjustment Coding to oversee daily operations and ensure accurate coding practices. The role includes managing workflows, implementing quality initiatives, and collaborating with stakeholders to enhance patient...Risk
- CINQCARE is seeking a Sr. Director of Risk Adjustment in Washington, D.C. This senior role focuses on designing and executing the risk adjustment strategy using advanced analytics, machine learning, and predictive modeling. The successful candidate will manage a multidisciplinary...RiskFlexible hours
- CINQ CARE Inc. is seeking a Sr. Director of Risk Adjustment to lead the enterprise-wide risk adjustment strategy utilizing advanced analytics and machine learning. This pivotal role involves collaborating with clinical and operational teams while managing a diverse group...Risk
- CVS Health is seeking a Lead Director - Revenue Integrity Informatics (Medicaid) to lead Medicaid risk adjustment analytics, reporting, and informatics to ensure complete, accurate, and compliant revenue capture. The role oversees strategic leadership, performance analytics...Risk
- Humana Inc is seeking a Director of Risk Adjustment & Quality Record Retrieval to lead the operational team focused on retrieving medical records for Risk Adjustment initiatives. This role involves overseeing a national workforce of 300 and driving performance through data...Risk
- Humana Inc is seeking a Director of Risk Adjustment & Quality Record Retrieval based in Hartford, CT, to lead a team of 300. This role involves managing operations focused on medical record retrieval, ensuring process optimization and effective communication across the...RiskRemote job
- Humana Inc. is seeking a Director of Risk Adjustment & Quality Record Retrieval to lead a national, remote workforce of 300 associates and drive all retrieval operations tied to Risk Adjustment and Quality priorities. The role focuses on performance management, escalation...RiskRemote job
$150k - $206.3k
Humana Inc is looking for a Director of Risk Adjustment & Quality Record Retrieval to lead a national remote team of 300 associates. The role involves managing retrieval operations, driving performance through data-informed decisions, and fostering collaboration across...RiskRemote job- CVS Health is seeking a Lead Director - Revenue Integrity Informatics (Medicaid) to guide Medicaid risk adjustment analytics, reporting, and informatics, ensuring accurate revenue capture and compliance. In this senior role you will drive strategic leadership, performance...Risk
- CVS Health is seeking a Lead Director - Revenue Integrity Informatics (Medicaid) to lead Medicaid risk adjustment analytics, reporting, and informatics, ensuring accurate revenue capture across markets and plans. The role drives strategic leadership, performance analytics...Risk
$210k - $250k
Role Description We have an opportunity to join the Alliance as the Risk Adjustment Director leading the Risk Adjustment Department. This position can be located in one of our service counties (Mariposa, Merced, Monterey, Santa Cruz, or San Benito) or remotely in California...RiskFull timeContract workLocal areaRemote workCentral California Alliance for Health
Remote14 hours ago- CVS Health is seeking a Lead Director - Revenue Integrity Informatics (Medicaid) to provide strategic leadership for Medicaid risk adjustment analytics, reporting, and informatics. You will drive accuracy, compliance and revenue capture while guiding cross‑functional teams...Risk
- CVS Health is seeking a Lead Director of Revenue Integrity Informatics (Medicaid) to guide Medicaid risk adjustment analytics, reporting, and informatics. This senior role shapes strategy, ensures accuracy, and drives value across markets and plans. Responsibilities include...Risk
- Humana, Inc is seeking a Director of Risk Adjustment & Quality Record Retrieval to lead a national, remote operations team of 300 associates. You will drive risk adjustment chart review, audits, and quality initiatives while aligning with enterprise stakeholders to optimize...RiskRemote job
$7,379.78 - $8,970.17 per month
...Annually: $88,557.36 - $107,642.04 Job Type: Permanent Full-Time Location: Martinez, California Department: Risk Management Job Title: Workers' Compensation Claims Adjuster II Contra Costa County is seeking two (2) Workers' Compensation Claims Adjuster II to join our Risk...RiskHourly payPermanent employmentFull timeTemporary workRemote workPrismrisk
Martinez, CA1 day ago$67.9k - $199.14k
## Senior Informatics Manager, Risk Adjustment Analytics RemoteApplyremote type: Remotelocations: Work At Home-Massachusetts: Work At Home-Arkansas: Work At Home-Idaho: Work At Home-Texas: Work At Home-Georgiatime type: Full timeposted on: Posted Yesterdaytime left to apply...RiskHourly payFull timeTemporary workWork experience placementLocal areaRemote workWork from homeCVS Health
Wausau, WI2 days ago
