Average salary: $54,216 /yearly
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- ...clinical ethics. Our core values are compassion, integrity, humility, excellence, justice, teamwork, and wholeness. Position: Coder 1 - Risk Adjustment The Coder 1 - Risk Adjustment is responsible for clinical documentation review related to Risk Adjustment Data Validation...RiskWork at office
- ...differences and capitalize on our similarities to better serve our communities. We do it because it's right! Job Description The Risk Adjustment Coder I provides support and coding expertise to all programs supporting risk adjustment and data validation efforts for Medicare...RiskWork at office
- ...vision for healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses... ..., ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical role in...RiskFull timeRemote workFlexible hours
- ...Description Description We are currently seeking a highly motivated Risk Adjustment Coding Specialist. This role will report to a Sr. Manager -... ...informal discussion and overread assignments. Supports coder training and orientation as requested by manager. May assist...RiskWork at officeMonday to Friday
- ...Utilizes analytics to identify and target providers for Medicare Risk Adjustment training and documentation/coding resources + The Medicare... ...small groups of clinicians, practice managers and certified coders developing training to fit specific provider's needs + Educates...RiskMinimum wageFull timeWork experience placementWork at officeLocal areaRemote workWork from homeRelocationRelocation packageMonday to Friday
- ...Job Title: Junior Quality Improvement Coder Target Compensation Range: $25.00 - $27.00/hour, depending on the relevant qualifications... ...that allows for proper review of data to evaluate HEDIS and Risk Adjustment Factor. Conduct internal reviews of documentation and...Risk
Astiva Health, Inc
Orange, CA3 days ago - Program Manager III - Risk Adjustment/Chart Review The Program Manager III for Risk Adjustment and Chart Review is responsible for overseeing the accuracy and efficiency of risk adjustment processes and retrospective chart reviews. They will support the management and...RiskContract workLocal area
- Overview: The Prospective Risk Adjustment Operations team is seeking a Program Manager to lead the planning, execution, and oversight of strategic initiatives that support prospective Medicare risk adjustment efforts. This pivotal role will be responsible for coordinating...RiskContract workLocal area
- Risk Adjustment Data Integrity (PM IV) The Program Manager will manage Risk Adjustment Data Integrity Programs across multiple organizations and align with strategic business goals across departments. Responsible and accountable for achieving program outcomes from initiation...RiskContract workLocal area
- ...Job Summary: This role will focus on advancing actuarial insights that improve risk adjustment performance across Medicare Advantage and ACA populations. Key areas of emphasis include HCC model analytics, forecasting of RAF scores, and the development of predictive...RiskFull timeWork experience placementWork at officeRemote workShift work
- Technical Summary: The Prospective Risk Adjustment Operations team is seeking a highly accomplished director to lead large-scale programs and components within Prospective Risk Adjustment Operations. This pivotal leadership role encompasses accountability for achieving...RiskContract workLocal area
- ...all Senior HMO members' medical records to ensure accuracy of Risk-Adjustment data and reimbursement. Maintain a professional, positive and... ...High school graduate or equivalent. Certified Professional Coder (CPC). Must maintain certification Completion of anatomy course...RiskRelocation package
- . Remote Coding Auditor - Risk Adjustment Are you a risk adjustment coder that is wanting to expand into an auditing role?Do you have 3 years or more of risk adjustment coding experience? Perks: ~ Flexible, full time schedule ~ Stable and ongoing consulting...RiskRemote jobFull timeOngoing contractFlexible hoursSundayMonday to Friday
- ...diverse professional, educational, and life experiences to realize our bold vision for healthcare. What we're looking for: The Risk Adjustment Analytics Manager will oversee the Business Analytics team, guiding analysts and contributing hands-on to data analysis. The ideal...RiskWork at officeRemote work
- ...do it all with heart, each and every day. CVS Health has an exciting opportunity for an Informatics Manager to join our dynamic Risk Adjustment Analytics team! In this role, you will support data analysis, predictive modeling, and evaluation reporting within our Medicaid...RiskHourly payFull timeTemporary workWork experience placementLocal areaFlexible hours
- ...committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a(an) Manager of Quality - Risk Adjustment Programs today with HCA Healthcare. **Benefits** HCA Healthcare, offers a total rewards package that supports the health, life,...RiskFull timeTemporary workPart timeFlexible hours
- Description The Director for Quality and Risk Adjustment is responsible for leading enterprise development of the Medicare Star Ratings and Enterprise Risk Adjustment strategies that ensure our risk adjusted and Star members are getting the right clinical and pharmacy...RiskPermanent employmentContract workTemporary workRemote work
- Job Summary: The Director of Risk Adjustment Data & Analytics is responsible for the overall strategy and direction for analytics involving risk score performance and forecasting trends within the National Risk Adjustment team. This role will be supporting the development...RiskWork experience placementLocal area
- Job Summary: This role will focus on advancing actuarial insights that improve risk adjustment performance across Medicare Advantage and ACA populations. Key areas of emphasis include HCC model analytics, forecasting of RAF scores, and the development of predictive models...RiskWork experience placementLocal area
- Description As the Medicare Advantage Risk Adjustment Performance Improvement Consultant, you will be responsible for: + Serving as a Subject Matter Expert (SME) for risk adjustment with contracted IPAs + Collaborating with IPAs on risk adjustment strategies to achieve...Risk
- ...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...RiskFor contractorsWork at officeLocal area
- ...realize our bold vision for healthcare. The Coding Supervisor serves as a working supervisor with oversight and management of Risk Adjustment team members. This includes monitoring production and quality of employees' work, process improvements and clear communication...RiskRemote workFlexible hours
- ...to Expect (Job Responsibilities): - Conduct research, analysis, and modeling of complex healthcare claims, pharmacy, lab, and Risk Adjustment submissions data - Develop and present reports on Risk Adjustment intervention performance and make data-driven recommendations...RiskRemote jobImmediate start
- ...realize our bold vision for healthcare. The Coding Supervisor serves as a working supervisor with oversight and management of Risk Adjustment team members. This includes monitoring production and quality of employees' work, process improvements and clear communication...RiskRemote workFlexible hours
- ...professional, educational and life experiences to realize our bold vision for healthcare. **Role Overview** As a Product Manager, Risk Adjustment Analytics Products, you will contribute to the strategy and execution of analytics capabilities that power Datavant's risk...Risk
- **Become a part of our caring community and help us put health first** The Director, Risk Adjustment Strategy Advancement will provide business intelligence and strategic planning support for business segments and the company at large. The Director, Risk Adjustment Strategy...RiskFull timeTemporary workFor contractorsApprenticeshipWork at officeRemote workWork from homeHome office
- Senior Liability Claims Adjuster - Tribal First Friday, May 16, 2025 Alliant Insurance Services is one of the nation’s largest and fastest... ...service. Alliant is changing the way our clients approach risk management and benefits, so they can capitalize on new opportunities...RiskWork at officeLocal areaImmediate start
- Senior Liability Claims Adjuster - Tribal First Friday, May 16, 2025 Alliant Insurance Services is one of the nation’s largest and fastest... ...service. Alliant is changing the way our clients approach risk management and benefits, so they can capitalize on new opportunities...RiskWork at officeLocal areaImmediate start
- ...reports, meetings, and status updates, etc.). + Identify project risks that impact the quality of our product and services delivery to... ...on continuous improvement. + Familiarity with CMS HCC risk adjustment processes preferred \#LI-BC1 We are committed to building a diverse...Risk
- Description As the Business Data Analyst for our Medicare Advantage Risk Adjustment team, you will be responsible for producing accurate and insightful department measurements used in both internal and external reporting. You will: + Ensure data quality and accuracy through...Risk
