Get new jobs by email
- ...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
- ...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
- ...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
$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, CA4 days ago- 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 and Quality...RiskContract workLocal areaImmediate start
- ...Design scalable workflows and controls across intake, adjudication, adjustments, appeals/grievances, and payment integrity. Technology... ...change management (training, SOPs, job aids, communications). Risk, Compliance & Quality: Ensure alignment to CMS, HIPAA, state regulations...Risk
- Overview The Risk & Quality Performance Manager position will support Molina’s Risk & Quality Solutions (RQS) team. This position collaborates... ...years of program and/or project management experience in risk adjustment and/or quality 2+ years of experience supporting HEDIS engine...RiskWork at office
$86k - $172k
Yamaha has an excellent opportunity for a Risk Manager II to join our Financial Services team in Cypress, CA . The Risk Manager II... ...risk initiatives like scorecard development, strategy design and adjustments. Perform quantitative analysis and monitor company's credit,...RiskHourly payTemporary workWork experience placementLocal area- PURPOSE To support the Risk Management department in the timely and accurate handling of workplace injury claims by maintaining organized... ...-to-work plans. Support communication with third-party claims adjusters and internal teams. Ensure all information is handled...RiskPermanent employmentWork at officeShift workNight shift
- ...of new programs and services. Monitor program outcomes and make adjustments as needed to improve effectiveness and patient satisfaction.... ...make informed decisions that drive organizational success. Risk Management: Experience in identifying, assessing, and mitigating...RiskFull timeContract workLocal areaFlexible hoursWeekend workDay shift
Roots Through Recovery
Long Beach, CA1 day ago $129.77k - $165.27k
About This Role As a Risk Adjustment Data Scientist at myPlace Health, you’ll do more than work with numbers—you’ll help shape how we care for the communities we serve. In this role, you’ll partner closely with business, clinical, and operational leaders to uncover high...RiskWork at officeMonday to Friday2 days per week- Overview Your Role The Risk Adjustment Retrospective Analytics team focuses on delivering complete and accurate analytics for chart review targeting, financial impact calculations, and data submission. The Actuarial Analyst, Consultant, will report to the Manager of Risk...Risk
$79.04k - $126.88k
...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 and...RiskFull timeContract workImmediate start$129.77k - $165.27k
...Health. Your actual pay will be based on your skills and experience — talk with your recruiter to learn more. About This Role As a Risk Adjustment Data Scientist at myPlace Health, you’ll do more than work with numbers—you’ll help shape how we care for the communities we...RiskWork at officeLocal areaRemote workMonday to Friday2 days per week$89.9k - $160.6k
...financial modeling tools, spreadsheets and information acquisition tools Experience with provider capitation, both diagnostic risk-adjustment and age/sex adjusted rate banding Experience in interpreting and reviewing financial modeling results to evaluate financial impact...RiskRemote jobMinimum wageFull timeContract workWork experience placementLocal area- Overview Job Description The AVP, Clinical Data Acquisition is a key Risk Adjustment (QI) leader within the organization enterprise wide. This position advises senior management, other corporate departments, and Molina health plans on Risk Adjustment/RADV data collection...RiskWork experience placementLocal area
- ...management and other processes relative to the business. Project management includes estimating, scheduling, costing, planning, and issue/risk management. Knowledge/Skills/Abilities Ability to provide strategic leadership on projects while also managing multiple,...RiskFull timeWork experience placementRemote work
Molina Healthcare
Long Beach, CA21 days ago $95k - $140.6k
...Implementrisk management strategies to identify, assess, and mitigate risks associated with configuration management. Minimum Qualifications... ...several projects at any given time, and the flexibility to adjust for abrupt changes in strategic direction. Experience with...RiskPermanent employmentFull timeTemporary workFlexible hoursWeekend workAfternoon shift- ...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 Corp.
Torrance, CA17 days ago - ...management as well as aftercare planning, group psychotherapy, suicide risk assessment and crisis intervention. Primary Duties and... ...placement under observation due to suicide risk or inability to adjust within general population due to symptoms of mental illness....RiskWorldwide
The GEO Group, Inc.
Long Beach, CA15 days ago - ...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
- ...Job Summary Molina Risk & Quality Solutions (RQS) works with health plan risk & quality leaders to support implementation of best... ...management responsibilities ~ Proven experience in risk adjustment, quality, and provider engagement. ~ Demonstrated ability to...RiskFull time
Molina Healthcare
Long Beach, CA21 days ago $150k - $175k
...education, performance, and compliance. Provide interim DON support as needed to maintain clinical continuity. Contribute to risk management, policy development, and quality improvement initiatives. Qualifications Active California RN license (required)...RiskFull timeInterim roleRelocation packagePACS
Long Beach, CA7 days ago- ...applicable laws, regulations, and industry standards. Implement and enforce best practices in design processes, sustainability, and risk management. Team Leadership and Development Lead and mentor design teams, fostering creativity, innovation, and professional...RiskFor contractors
CTI Environmental, Inc.
Long Beach, CA28 days ago - ...collaboration. Develop and implement strategic planning initiatives to align with organizational goals. Communicate project status, risks, and issues to stakeholders and senior management. Resolve conflicts and address any challenges that arise during project...RiskOngoing contractLocal areaRemote workRelocation
CyberCoders
Carson, CA1 day ago $176k - $225.5k
...and provide visibility to cross-functional teams. Programmatic Risk Management :Identify and manage program risks (time, requirements... ...robust, scalable solutions Experience communicating effectively, to adjust approach across stakeholders and teams and to navigate both...Risk- Overview The Director, Clinical Data Acquisition for Risk Adjustment is responsible for the implementation, monitoring, and oversight of all... ...be preferred for specific roles) • Certified Risk Adjustment Coder (CRC) To all current Molina employees: If you are interested in...RiskImmediate start
- ...to revolutionize the Medicare health assessment landscape by delivering high-quality, patient-centered care through innovative risk adjustment models. Operating across multiple states and rapidly expanding, Transtreme partners with health organizations and primary care...RiskFlexible hours
Transtreme
Long Beach, CA12 days ago - ...work remotely from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities Lead the end-to-end risk adjustment strategy and execution, including data capture, gap closure, and CMS submission processes, ensuring accuracy, compliance, and...RiskRemote jobMinimum wageFull timeWork experience placementLocal area
