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- ...Managing a team responsible for external audits, the full-time Compliance Risk Adjustment Manager will ensure compliance and reporting accuracy while working remotely from anywhere in the Continental United States. Key responsibilities Serve as the point of contact for...RiskFull timeRemote work
Virtual Vocations Inc
United States5 days ago - ...Group is seeking a Director to lead strategies for Burden of Illness initiatives, ensuring accurate documentation and compliant risk adjustment across physician practices. You will translate organizational goals into actionable programs, coordinating with Risk Adjustment...Risk
Millennium Physician Group
Tallahassee, FL3 days ago - ...Humana, Inc. is seeking a Director of Risk Adjustment Regulatory Audits to lead strategy and execution of external audits. This remote role partners with crossfunctional teams and regulatory bodies to optimize audit intake, submission, and outcomes. You will drive analytics...RiskRemote work
Humana
Frankfort, KY1 day ago - ...L.A. Care Health Plan is seeking a Director, Risk Adjustment Strategies and Initiatives in Los Angeles to lead enterprise risk adjustment programs, AWEs, and Medicare STAR initiatives with cross-functional teams. Responsibilities include developing strategic plans,...Risk
LACare Inc
Los Angeles, CA5 days ago - ...coordinate coding operations, audit coding and documentation, and develop education for coders, providers, and staff. The ideal candidate has five or more years in risk-adjustment coding and auditing, and holds CPC or RHIT and CRC credentials; CPMA is aPlus. #J-18808-LjbffrRiskFull timeRemote workWork from home
University Physicians Group
United States3 days ago - ...Oscar Health is seeking a Senior Director of Actuarial – Risk Adjustment to lead the ACA risk adjustment function, forecast financials, and deliver insights to executive leadership. The role oversees analytics across Finance, Market P&L, Risk Adjustment Operations, Medical...RiskRemote work
Acturhire
New York, NY2 days ago - ...Humana Inc. is seeking a Director of Risk Adjustment Regulatory Audits to lead the strategy and execution of external regulatory audits nationwide. This remote role emphasizes strong operational processes, analytics, and cross-functional collaboration with Humana’s teams...RiskRemote work
Humana
New York, NY3 days ago - ...CVS Health Corporation is seeking a Lead Director of Informatics to lead enterprise risk adjustment analytics and BI solutions. You will transform clinical and claims data into actionable insights to drive provider performance and program efficiency, leveraging AI, advanced...Risk
CVS Health
Little Rock, AR4 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- ...Optum in New York, NY is seeking an Executive Director of Risk Adjustment to lead enterprise risk adjustment strategy and operational performance across networks. This role directly influences financial performance through accurate risk capture and compliant coding in...Risk
Optum
New York, NY4 days ago - ...CVS Health is seeking a Lead Director, Informatics (Performance Reporting & Insights) to drive enterprise risk adjustment analytics and BI solutions. You will transform clinical and claims data into actionable insights, shaping provider performance and executive decision...Risk
CVS Health
Austin, TX3 days ago - ...Strategic Staffing Solutions in Baton Rouge, LA seeks an experienced Risk Adjustment Coder with Medicare Advantage and ACA risk adjustment coding expertise. The role focuses on accurate ICD-10-CM coding, medical record reviews, documentation validation, and QA activities...RiskRemote work
Strategic Staffing Solutions
Baton Rouge, LA5 days ago - ...of New Jersey is seeking a senior analytics professional to lead vendor management and performance measurement for Enterprise Risk Adjustment. You will drive KPI frameworks, negotiate contracts, and partner with commercial, Medicare, and Medicaid programs to optimize vendor...Risk
100 Horizon Healthcare Services, Inc
Newark, NJ5 days ago - ...Stanford Health Care seeks a Clinical Documentation Specialist-Risk Adjustment to lead risk adjustment coding activities in Palo Alto. The role focuses on CDI, prospective/concurrent reviews, and education across departments to ensure accurate HCC coding and regulatory...Risk
LE0010 Stanford Health Care
Palo Alto, CA4 days ago - ...Blue Cross and Blue Shield of Vermont is seeking a Provider Engagement Consultant to join our Risk Adjustment team in Berlin, VT. The role focuses on engaging providers, educating on risk adjustment processes, and driving performance improvements through collaboration...Risk
Automatic Data Processing
Berlin, VT3 days ago - ...Astrana Health, Inc. is seeking a Risk Adjustment Coding Specialist II to support Houston market. Travel to provider offices is required twice weekly, with responsibilities including chart reviews, HCC coding, and education delivery to providers. Candidate will review...Risk
Astrana Health, Inc.
Houston, TX1 day ago - ...Review medical records to validate reportable diagnoses and coding accuracy. Apply MEAT criteria and CMS guidelines for risk adjustment. Qualifications: CRC or related risk adjustment certification required. Minimum 2 years of HCC coding and risk adjustment experience....RiskRemote work
Bluestone.com
United States1 day ago - ...lower or higher than the one presented depending on the location. Technical Summary: The Director, Process Improvement, Risk Adjustment Oversight provides strategic oversight of risk adjustment processes, with a focus on data submission, data integrity, risk mitigation...RiskTemporary workFlexible hours
Kaiser Permanente International
Denver, CO1 day ago $154.13k - $204.21k
...inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience! Reporting to the Vice President, Risk Adjustment, the Director of Risk Adjustment Prospective Programs is a strategic leader responsible for implementing, operationalizing, and...RiskTemporary workImmediate startFlexible hoursIEHP
Rancho Cucamonga, CA3 days ago- ...Medica is seeking a senior Risk Adjustment Healthcare Analyst (P3) to deliver complex analytics and reporting that support the organization's risk adjustment strategy. You will translate healthcare data into insights that inform financial performance, coding accuracy,...Risk
Medica Services Company LLC
Minnetonka, MN5 days ago $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$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 areaCVS Health
Salem, OR4 days ago$63.98k
...Job Description Summary Under the direction of the Risk Adjustment Manager, the Risk Adjustment Supervisor is responsible for providing first-line supervision for the Risk Adjustment Coding Specialist. Supervisor responsibilities include but are not limited to daily supervision...RiskMillennium Physician Group
New York, NY4 days ago- ...Risk Adjustment Coding SpecialistWe 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 will...RiskFull timeRemote workDay shift
Trinity Health PACE
Boise, ID3 days ago - ...Working remotely in a full-time capacity, the Senior Risk Adjustment Analyst will support Medicare Advantage and ACA Risk Adjustment programs by managing risk adjustment analytics and improving coding capture and revenue optimization. Key responsibilities Perform risk...RiskFull timeRemote work
Virtual Vocations Inc
United States1 day ago $70k - $85k
...Astrana Health, headquartered in California, seeks a Risk Adjustment Coding Specialist II to support their Los Angeles area operations. The role focuses on reviewing chart data to identify coding gaps, educating providers, and tracking key KPIs, with up to 30% travel to...RiskAstrana Health Management
Monterey Park, CA1 day ago- 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
$65.87 - $112.02 per hour
...Street, Hartford, CT Schedule: Full Time System: Hartford HealthCare, Connecticut’s most comprehensive health system Director, Risk Adjustment & Quality Hartford HealthCare, Connecticut Shape the Future of Value-Based Care At Hartford HealthCare, we are transforming healthcare...RiskHourly payFull timeHartford Healthcare
Hartford, CT2 days ago- ...Cambia Health Solutions is seeking a Temporary Risk Adjustment Campaign Associate to support Medicare Advantage and Commercial risk adjustment campaigns from home in OR, WA, ID or UT. This 5-month, non-benefited assignment focuses on daily operations and EMR medical record...RiskTemporary workRemote work
Cambia Health Solutions
United States5 days ago - ...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
