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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 $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- ...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, MO5 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$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 States5 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
$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$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$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
- ...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
- Millennium Physician Group seeks a Medicare Risk Adjustment (MRA) Coding Specialist to support accurate risk adjustment coding and documentation initiatives. You will analyze coding and documentation trends, perform retrospective chart reviews, and assign ICD-10-CM codes...Risk
- Bluestone Physician Services is seeking a detail-oriented Certified Risk Adjustment Coding Specialist to conduct thorough chart reviews and accurately capture risk adjustment diagnoses. This remote role requires Florida residency and a CRC or equivalent certification, with...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
- 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
- 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
- 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
- ...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
$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 States5 days ago- ...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, MN28 days ago - 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
- 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
- Clever Care Health Plan in Huntington Beach, CA is seeking a Risk Adjustment Coordinator, Chart Retrieval. The role manages end-to-end medical record retrieval to support the Medicare Advantage RADV program, coordinating with PCP offices, hospitals, and providers to improve...Risk
- Clever Care Health Plan in Huntington Beach, CA, is seeking a Senior Risk Adjustment Operations Specialist to translate coding findings into provider education and actionable workflow improvements at the point of care. You will partner with risk adjustment, quality, IT,...Risk
- Astrana Health is seeking a Risk Adjustment Coding Specialist to support our Orange County market. You will review charts, identify coding gaps, and educate providers to improve accuracy in HCC documentation, while tracking KPIs and guiding performance improvements. The...Risk
- City of Virginia Beach is seeking a skilled Worker’s Compensation Adjuster within the Risk Management division of the Finance department. The ideal candidate will handle complex claims, review injury reports for accuracy, and coordinate with a third‑party administrator...RiskWork at office
$118.6k - $157.14k
...and inspiring the human spirit” and to pivot from a “job” opportunity to an authentic experience!Reporting to the Director of Risk Adjustment Prospective Programs, the Manager of Risk Adjustment Encounter Data Reconciliation is a highly technical, data-driven day-to-day...RiskTemporary workWork experience placementLocal areaRemote workMonday to FridayInland Empire Health Plan
Rancho Cucamonga, CA3 days ago- Clever Care Health Plan in California is seeking a Risk Adjustment Coordinator, Chart Retrieval, to oversee end-to-end medical record retrieval for the Medicare Advantage program. You will engage PCP offices, hospitals, and IPAs to collect complete records needed for HCC...Risk
- ...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
