- Datavant (Olympia, WA)
- …mindset and a focus on continuous improvement. + Familiarity with CMS HCC risk adjustment processes preferred \#LI-BC1 We are committed to building a diverse ... in Business, Operations Management, or a related field; MBA or equivalent advanced degree preferred . + At least 8 to 10 years of experience in healthcare technology… more
- Evolent (Olympia, WA)
- …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...problem-solving skills, and proficiency in clinical documentation requirements. **Qualifications Preferred :** + Clinical knowledge of chronic conditions and comorbidities.… more
- 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
- 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)
- …This Sr. Analyst, Healthcare Analytics role will support Molina's Risk Adjustment Analytics team. The job responsibilities include developing risk score reporting ... Databricks + Bachelor's Degree in Finance, Economics, Math, or Computer Science ** Preferred Experience** Preferred experience in Medical Economics and Strong… 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
- Evolent (Olympia, WA)
- …systems is preferred + **Background in value-based care** models, risk adjustment , and quality measurement programs is preferred + **Experience with ... outcomes + **5+ years of hands-on experience** implementing HL7 FHIR (R4 preferred ) in complex healthcare environments + **Expert knowledge** of healthcare standards… more