- 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 to partner directly with primary care organizations across the country to improve patient… more
- Molina Healthcare (Austin, TX)
- …Analysis and forecasting of program value and underlying population trends in risk adjustment to provide analytic support for finance, pricing and actuarial ... will be responsible for work around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling of complex… more
- Molina Healthcare (TX)
- …and present findings to leadership + Generate and distribute routine reports to support risk adjustment calculations, pricing, and financial reporting + Identify ... Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintain risk adjustment model, estimate… more
- Datavant (Austin, TX)
- …+ **Domain Expertise:** Well-versed in the key underlying healthcare data sources that support risk adjustment coding, including standards such as HL7, FHIR, CMS ... 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… more
- Molina Healthcare (Austin, TX)
- …and maintain risk score models. + Generate and distribute routine reports to support risk adjustment calculations, pricing, and financial reporting. + Extract ... **JOB DESCRIPTION** **Job Summary** Responsible for Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and reporting.… more
- Molina Healthcare (San Antonio, TX)
- …tracking, chart retrieval, file transmissions, and adherence to applicable timelines * Support all risk adjustment audit related projects to ensure goals, ... in the daily operations of all aspects of risk adjustment data validation related activities, including, but not limited...and Medicaid Services (CMS) regulations and guidelines of risk adjustment data * Understand and oversee RAPS and EDPS… more
- Molina Healthcare (Houston, TX)
- **JOB DESCRIPTION** **Job Summary** This Sr. Analyst, Healthcare Analytics role will support Molina's Risk Adjustment Analytics team. The job responsibilities ... large and varied data sets, analyzing healthcare data for decision support , and communicating findings. Qualified candidates are the diligent problem solvers… 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)
- **JOB DESCRIPTION** **Job Summary** Provides support to the business by making sure proper ICD-10 and CPT codes are reported accurately to maintain compliance and to ... network of providers on how to improve their risk adjustment knowledge as well as provide coding updates related...as well as provide coding updates related to Risk Adjustment + Builds positive relationships between providers and Molina… more
- Clements Fluids (Tyler, TX)
- …accounts. + Identify and investigate anomalies or trends that require resolution or adjustment . + Provide support for financial audits, variance analysis, or ... payable (AP) and accounts receivable (AR) functions, while also providing support for month-end accounting processes. UNLIKE a standard processing role, this… more