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- ...Minimum five years of clinical practice experience. Experience in value-based care population health Medicare Advantage risk adjustment clinical documentation improvement or quality initiatives. Demonstrated physician leadership experience. Director Risk Adjustment...RiskFull time
Hartford Healthcare
Hartford, CT3 days ago $87.7k - $157.8k
...Postition Purpose: Manages a team responsible for facilitation and leading external audits related to Risk Adjustment processes. Ensures visibility by way of reporting out audit deliverables and associated risk related for each audit. Collaborates with business areas...RiskFull timePart timeWork at officeRemote workWork from homeFlexible hours- ...Job Description: This professional position is assigned the responsibility and accountability to manage and coordinate the risk adjustment programs for Cox HealthPlans (CHP). This manager will work with other staff and leaders within CHP to ensure risk-adjusted...RiskShift workDay shift
CoxHealth
Springfield, MO2 days ago - ...Astrana Health seeks a Sr. Director of Risk Adjustment to lead risk adjustment, clinical documentation improvement, provider engagement, and population health strategies. This leader will guide Senior Managers, Managers, and teams, translating enterprise priorities into...RiskRemote work
- 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
$102.4k - $138.3k
...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 weekBlue Cross Blue Shield of Minnesota
Eagan, MN2 days ago$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, CA2 days 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 States1 day ago$87 per hour
...have opportunities for you to join our amazing team of healthcare professionals right in your neighborhood. The Manager Risk Adjustment and Coding at Johns Hopkins Community Physicians is a dynamic leadership role responsible for strategic oversight of ambulatory...RiskFull timeLocal areaShift workJohns Hopkins Medicine
Baltimore, MD13 days ago- ...Risk Adjustment Coding Specialist We are currently seeking a highly motivated Risk Adjustment Coding Specialist to support our Houston market. In this role, you will support risk adjustment efforts by conducting high-volume chart reviews to identify coding gaps, trends...Risk
- ...Footprint is in the following states, MS, AR, AL, TN, GA, NC, and SC. POSITION AVAILABLE - LOST-TIME CLAIMS ADJUSTER The Claims Adjuster with SteadPoint Risk Management Solutions is responsible for administering and managing workers' compensation claims from initial...Risk
SteadPoint
Birmingham, AL6 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, and...Risk
- 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
- ...Anticipated End Date: Position Title: Business Change Manager Sr (Risk Adjustment Coding) Job Description: Business Change Manager Sr (Risk Adjustment Coding) Hybrid : This role requires associates to be in-office 1-2 days per week fostering collaboration...RiskFull timeTemporary workWork at officeLocal area2 days per week1 day per week
Elevance Health
Indianapolis, IN13 days ago - ...Claims Adjuster A.G. Risk Management, Inc. is a growing and dynamic business operating in the global insurance and reinsurance market, focusing on the Property & Casualty (P&C) market. We currently have offices in Philadelphia PA, Quincy MA, and Buffalo, NY. We have...RiskWork at officeRemote workFlexible hours
Alan Gray - A Premia Reinsurance Company
United States5 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: Ideal candidate to live in the state of PA. Develop and implement action plans, across all departments...RiskFull timePart timeWork experience placementLive inWork at officeLocal areaRemote workFlexible hours- ...Risk Adjustment Specialist Location: Birmingham, Alabama Job Summary The Risk Adjustment Specialist ensures all ICD-10 codes are documented for the assignment of valid and accurate HCCs for each record reviewed for submission to the Centers for Medicare & Medicaid...RiskImmediate startFlexible hours
Bham-Corporate Office
Birmingham, AL1 day ago - ...experience to match. Our mission is to deliver highly personalized risk and claims management through a blend of expert independent... ...opportunity employer. Responsibilities This Senior Casualty Claim Adjuster role requires deep, proven casualty claim experience and is...RiskFull timeWork experience placementWork at officeRemote workFlexible hours
W. R. Berkley
Scottsdale, AZ1 day ago $70k - $85k
...We are currently seeking a highly motivated Risk Adjustment Coding Specialist to support our Houston this role you will support risk adjustment efforts by conducting high-volume chart reviews to identify coding gaps trends and opportunities for improved accuracy for our...RiskFull timeLive inWork at officeRemote workHome officeAstrana Health
Arizona9 days ago- Centene Corporation is seeking a Risk Adjustment Audit Manager to oversee external audits and lead delivery of audit deliverables. The role focuses on ensuring accuracy, regulatory alignment, and timely communication with auditors across the risk adjustment function. You...RiskRemote job
$160k - $195k
Sr. Director - Risk Adjustment Department: Quality - Risk Adjustment Employment Type: Full Time Location: 1668 S. Garfield Ave. 2nd Floor, Alhambra, CA 91801 Reporting To: Nallammai Vijayakumar Compensation: $160,000 - $195,000 / year Description We are seeking a strategic...RiskFull timeContract workRemote work- JOB SUMMARY: The Risk Adjustment Analyst II supports the organization’s Medicare Advantage (MA) and Affordable Care Act (ACA) risk adjustment programs by managing data submissions, developing reporting, and delivering actionable analytics. This role is responsible for ensuring...RiskWork at office
- Medica is seeking a senior Risk Adjustment Healthcare Analyst (P3) in Minnesota to translate claims data into actionable insights and support financial performance and regulatory compliance. You will own analytics, collaborate with actuarial, finance, clinical, and operations...RiskWork at office3 days per week
$95.77k - $116.41k
...Permanent Full-Time Job Number: AJVF-2024A Department: Risk Management Opening Date: 04/10/2024 Closing Date: Continuous... ...Costa County is seeking one (1) Workers' Compensation Claims Adjuster II to join our Risk Management team. The County Workers' Compensation...RiskPermanent employmentFull timeTemporary workWork experience placementWork at officeLocal areaImmediate startRemote workContra Costa County, CA
Martinez, CA2 days ago- ...company expertise. Our Crop Division has been helping farmers manage risk since 1915 and is one of the few private companies authorized by... ...part‑time. Hours fluctuate based on seasonal needs. As a Crop Adjuster, You Will Understand and work claims for all major crops, policy...RiskFull timePart timeSeasonal work
Great American Insurance Company
Louisiana, MO2 days ago $129.38k
...Job Description: Summary The Supervisor Risk Adjustment Quality Assurance and Auditing is responsible for oversight of the daily operations of the Risk Adjustment Quality Assurance Auditor team. This role ensures the accuracy compliance and quality of the risk adjustment...RiskFull timeContract workRemote workWork from homeHome officeUnivera Healthcare
Buffalo, IA5 days ago$83.99k - $119.97k
...company that continues to commit to putting our employees first. Job Description: OVERVIEW OF POSITION: The Program Manager, Risk Adjustment & Stars, serves as the connective link between Alpine's technical teams (coding, data, analytics, IT) and its operational and...RiskFull timeRemote workHome office- Stanford Health Care is seeking a Clinical Documentation Specialist-Risk Adjustment to perform code audits, abstraction, and education to support accurate risk adjustment coding across medical records and programs. The role requires collaboration with clinicians, review...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 States5 days ago- Description AvonRisk is the nation’s leading specialty risk manager for self-insured organizations, uniting respected regional leaders... ...succeed. Role Summary: As a Workers’ Compensation Claims Adjuster III at AvonRisk, you are a senior technical expert trusted with...RiskPermanent employmentWork at officeRemote work
