- Molina Healthcare (Bellevue, WA)
- …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 (Everett, WA)
- …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 (Olympia, WA)
- …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
- Datavant (Olympia, WA)
- …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 adjustment solutions. You'll drive the development of robust, scalable,...+ Define and own the product vision for risk adjustment analytics across retrospective and prospective use cases. +… more
- Molina Healthcare (Spokane, WA)
- …* 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
- Molina Healthcare (Vancouver, WA)
- **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
- Molina Healthcare (Spokane, WA)
- …Summary** The Senior Analyst will serve a key role on the RADV (Risk Adjustment Data Validation) team, contributing to the end-to-end data strategy and execution of ... for audit response. + Collaborate with internal stakeholders-including IT, Risk Adjustment operations, clinical teams, and retrieval vendors-to ensure accurate data… more
- Molina Healthcare (Vancouver, WA)
- …Summary** The Junior Analyst will play a supporting role on the RADV (Risk Adjustment Data Validation) team, assisting in the execution of CMS and internal audit ... required data elements. + Collaborate with internal teams-including IT, Risk Adjustment operations, and clinical teams-to ensure accurate and consistent data… more
- Datavant (Olympia, WA)
- …experiences to realize our bold vision for healthcare. As an Auditor, HCC Risk Adjustment Coder, you will review medical records to identify and code diagnoses using ... a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical role in… more
- Datavant (Olympia, WA)
- …a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical role in ... translating clinical documentation into precise codes that reflect the complexity and severity of a patient's health status. **You will:** + Review, analyze, and code diagnostic information in a patient's medical record based on client specific guidelines for… more