- Evolent (Austin, TX)
- …Be Doing:** **Manager, Coding Support Specialist** Evolent Care Partners is seeking a Risk Adjustment Coding Support Manager to be a core member of the Risk ... Adjustment Coding Support team. Evolent Care Partners' mission is...a passion for improving healthcare. **Collaboration Opportunities:** Our Risk Adjustment coding support team offers candidates the opportunity to… more
- Molina Healthcare (Austin, TX)
- …will be responsible for work around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling of complex ... healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data to evaluate healthcare intervention program performance. Develops and presents… more
- Molina Healthcare (TX)
- …Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintain risk adjustment model, estimate ... identify risks. Additional leadership opportunities are available to lead national risk adjustment studies. Prior experience in Medicaid risk adjustment is not… more
- Datavant (Austin, TX)
- …for healthcare. **Role Overview** As the Director of Prospective + Concurrent Risk Adjustment Products, you will lead the strategy, roadmap, and execution for the ... and acting on undiagnosed conditions (prospective suspecting) and ensuring risk adjustment coding accuracy in near real-time (concurrent review). You will manage… more
- Molina Healthcare (Fort Worth, TX)
- …training and education to network of providers on how to improve their risk adjustment knowledge as well as provide coding updates related to Risk Adjustment ... **Preferred Experience** + Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model + Background in supporting risk adjustment management… more
- Molina Healthcare (San Antonio, TX)
- …* Assist in the daily operations of all aspects of risk adjustment data validation related activities, including, but not limited to: progress tracking, ... transmissions, and adherence to applicable timelines * Support all risk adjustment audit related projects to ensure goals, objectives, milestones and deliverables… more
- Datavant (Austin, TX)
- …our bold vision for healthcare. **Role Overview** As a Product Manager, Risk Adjustment Coding Data Integration, you will own the data strategy and execution for ... Datavant's Retrospective Risk Adjustment Coding products, driving client data standardization, data integrations,...for the Data Integration pod within the Retrospective Risk Adjustment Coding Product Suite + **Execution & Delivery** +… more
- Molina Healthcare (Austin, TX)
- **JOB DESCRIPTION** **Job Summary** Responsible for Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and reporting. ... **KNOWLEDGE/SKILLS/ABILITIES** + Collaborate with Actuarial staff to calculate risk adjustment payment estimates. Document assumptions. + Analyze results to identify… more
- Centene Corporation (Austin, TX)
- …of department overseeing compliance with regulations and laws related to Risk Adjustment across our Marketplace, Medicaid and Medicare lines of business, which ... risk assessments oversight and the monitoring work plans pertaining to Risk Adjustment . Partners with business areas to ensure and implement effective prevention,… more
- Molina Healthcare (Houston, TX)
- …- Provider Engagement** plays a key role in driving risk adjustment and quality performance outcomes through effective program management, operational execution, ... Develop, review, and update Standard Operating Procedures (SOPs) for risk adjustment and quality program workflows. + Maintain accurate, up-to-date documentation of… more
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