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- Medical Director, Risk Adjustment Southern California preferred; Clark & Pima Counties, NV — Travel Required CareMore Health Make an Impact... ...advise from afar — you’ll partner closely with providers, coders, and cross-functional leaders to ensure the integrity, accuracy...Risk
$192.15k - $240.19k
...Medical Director, Risk Adjustment The Medical Director, Risk Adjustment will serve as the clinical expert responsible for advancing CareMore Health's risk adjustment strategy. This physician expert will guide providers in accurate and complete documentation of patient...RiskMosaic Health
Cerritos, CA1 day ago$71.3k - $82.6k
...outcomes. In this position you will administer and resolve highest risk management expectations claims in a timely manner in accordance... ...appropriate reserves with documented rationale, maintains and adjusts reserves over the life of the claim to reflect changes in exposure...RiskFull timeWork experience placementPMA Companies
Long Beach, CA5 days ago$200k - $280k
...Medical Director, Risk Adjustment Los Angeles, CA (Hybrid) Compensation: $200,000 $280,000 per year + Bonus Schedule: Full-Time | Hybrid (Onsite & Remote) Overview: Were seeking a Medical Director, Risk Adjustment to lead and advance our clinical risk adjustment...RiskFull timeRemote work- ...Industry: Healthcare Services Why consider this job opportunity: - Opportunity for career advancement and leadership in national risk adjustment studies - Competitive benefits and compensation package - Analyze and synthesize data to make a significant impact on Medicaid...RiskRemote jobImmediate start
- ...currently seeking an Assistant Manager of Credit/Pricing for our Risk and Analysis department. This position will report to the... ...reporting on the credit quality and performance, and recommends adjustments to credit policy as warranted by the analytics. The Assistant Manager...RiskTemporary workWork experience placementWork at officeRemote workRelocation package
American Honda Finance
Torrance, CA5 days ago - ...Industry: Healthcare Services Why consider this job opportunity: - Opportunity for career advancement and leadership in national risk adjustment studies - Competitive benefits and compensation package - Engage with data analysis to drive improvements in Medicaid risk...RiskRemote jobImmediate start
- Job Description Job Summary The Analyst, Risk Adjustment-Predictive Analytics role will support Molina's Risk Adjustment Predictive Analytics team. Designs and develops Suspect, Targeting, and Tracking System to support Molina’s Prospective and Retrospective Interventions...RiskWork at office
- ...South Los Angeles based FQHC looking for onsite Certified HCC coder . *This is not a remote position Conduct the necessary... ...the diagnoses then code these diagnoses in ICD-10 for Medicare Risk Adjustments/Medicare Advantage. Evaluate medical information (Outpatient...RiskWork at office
- ...accurately to maintain compliance, and minimize risk and denials. Contributes to overarching... ...to provider network regarding risk adjustment and coding updates related to risk adjustment... ...and experience. Certified Professional Coder (CPC). Certified Coding Specialist (CCS)....RiskWork at office
$110k - $135k
...management of client. Proactive development and execution of client risk management strategy. Knowledge of full portfolio of P&C... ...vision abilities required by this job include ability to adjust focus when using computers tablets or other electronic devices....RiskWork experience placementTriup, Inc
Torrance, CA2 days ago$63.14k - $77.51k
...Supervisor, to plan, organize, direct, and coordinate a comprehensive risk management program, to include administration of a risk... ...negotiations and recommend settlement of liability claims with adjusters, attorneys and claimants; • Work with City Attorney's office...RiskFull timeContract workFor contractorsWork experience placementWork at officeLocal areaCity of Huntington Park, CA
Huntington Park, CA21 hours ago$165k - $225k
...Workplaces in Financial Services & Insurance Sr. Executive General Adjuster (Remote in California) As an adjuster at Sedgwick, you'll have... ...for this or other roles. Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive by...RiskWork at officeLocal areaRemote workFlexible hoursSedgwick
Long Beach, CA3 days ago$30 - $33 per hour
...Thursday - Friday Remote Part B ~ Wednesday - Friday Onsite / Monday - Tuesday Remote We are looking for HCC Risk Adjustment Auditors/Coders to join our team! Position Summary: The HCC Risk Adjustment/Auditor is responsible for maintaining and...RiskHourly payFull timeCasual workWork at officeRemote workRelocation packageMonday to FridayFlexible hours$99k - $176k
...Job Description OPERATIONAL RISK FRAUD OVERSIGHT MANAGER II WHAT IS THE OPPORTUNITY? Operational Risk Management (ORM) is responsible for providing independent and objective oversight of the management of risks arising from City National Bank's business processes...RiskRemote workCity National Bank
Los Angeles, CA14 days ago$92k - $120k
...Risk Control Consultant Risk Control Consultant on the Strategic Risk Team (SRT) plays a key role in supporting underwriting, sales... ...to assess account performance, address concerns, and recommend adjustments. 4. Client Presentations: Present Strategic Risk management...RiskWork experience placementWork at officeRemote workFlexible hours- ...Job Description Job Description The Hospital Claims Adjuster is responsible for the adjusting of hospital risk claims, in accordance with outside regulations and the contractual obligations of the Health Plans and/or the Hospitals/IPAs. Research, reviews, and contacts...Risk
$63.59k - $121.53k
...impactful. The Opportunity As a dedicated Senior Property Adjuster, you will work within defined guidelines and framework,... ...assigned additional work outside normal duties as needed. Ensures risks associated with business activities are effectively identified,...RiskHourly payH1bLocal areaRelocationAfternoon shiftUSAA Careers
Los Angeles, CA1 day ago- ...8. Prepares comprehensive, timely executive-level reports with regular cadence to keep leadership aware of audit status, compliance risks, etc. 9. Fully and timely report to all appropriate leaders and staff of upcoming audits audit results, corrective actions so thet...RiskWork experience placement
Torrance Memorial
Torrance, CA3 days ago $1,263 per week
...that may indicate a need for intervention. Identify potential risks and complications, such as arrhythmias, respiratory distress,... ...telemetry, arterial lines, and other continuous monitoring devices, adjusting care as necessary. Provide post-surgical care for patients...RiskZero hours contractShift workNight shift- ...accidents to Assistant Sales Director or Retail District Manager and Risk Management Specialist IMMEDIATELY. Accountable for oversight... ...: Mission-Driven Leadership - Analyzes sales trends and adjusts strategy to exceed weekly and monthly revenue goals. Executes markdown...RiskLocal areaImmediate startFlexible hoursAfternoon shift
$37.96 - $60.64 per hour
...supporting remediation of regulatory, internal audit, and self-identified issues. Analyze, evaluate and periodically review current risk management practices relating to RNDIP activities across the organization, including activities at network affiliates. Collaborate...RiskHourly payWork at officeRemote workCity National Bank
Los Angeles, CA16 days ago- ...outcomes and assign follow-ups to ensure technical alignment and risk mitigation. Issue Resolution : Maintain a live project issue... ...consistent, data-driven updates to executive and technical stakeholders; adjust strategies and timelines as needed based on risk and performance...RiskRemote workWorldwide
- ...Identify and accurately document chronic conditions for HCC risk adjustment Perform thorough medication reconciliation and patient education... ...Qualifications: CRC (Certified Risk Adjustment Coder) certification Bilingual (Spanish/English) Experience with...RiskLocal area
Spencer Britt
Los Angeles, CA21 hours ago $99k - $176k
...Job Description SR. AUDIT MANAGER- ENTERPRISE RISK MANAGEMENT WHAT IS THE OPPORTUNITY? The Sr. Audit Manager position is a leadership role as an auditor-in-charge to guide a team of auditors to assess risks, develop detail audit programs, identify data analytic...RiskRemote workCity National Bank
Los Angeles, CA14 days ago- ...ERM Data Analyst assists in the execution of F&M’s Enterprise Risk Management (ERM) data management goals. This role emphasizes data... ...calibration of Verafin FRAML models by recommending parameters adjustments backed by statistical evidence. # Document tuning rationale...RiskContract workWork at officeImmediate start
Farmers and Merchants Bank of Long Beach
Lakewood, CA7 days ago $45k - $60k
...claims process, providing guidance and facilitating communication between clients and claims adjusters. - Monitor and follow up on claims to ensure timely resolution. Risk Management: - Identify potential risks and provide risk management advice to clients. -...RiskWork experience placementWork at officeMonday to FridayHumina Resource
Cypress, CA3 days ago$201k - $241.2k
...deductible and commercial accounts, OSP Program claims, and runoff risk management claims. The position manages two direct reports and... ...work we offer is challenging, diverse, and impactful. Our Adjusters and Managers are empowered to exercise their independent...RiskTemporary workWork at officeLocal areaArgonaut Management Services, Inc
Los Angeles, CA3 days ago- Risk Manager Job Duties : Leads the identification, communication, measurement, and management of company-wide risk. Manages insurance... ...participates in negotiations, conferences and mediations with adjusting companies, outside legal counsel, staff, claimants, and other...Risk
- Overview Job Description Job Summary The AVP, Quality & Risk Adjustment is responsible for leading health plan execution for Risk Adjustment and Quality for all lines of business, ensuring alignment of strategy and activities with Enterprise, acting as the Risk Adjustment...RiskContract workLocal areaImmediate start
