• Risk Adjustment Analyst, Health…

    University of Utah Health (Murray, UT)
    …responsibility, integrity, quality and trust that are integral to our mission. EO/AA_ + Risk Adjustment Analyst position provides support for our health plan's ... risk adjustment program. + This role is...Excel). + Familiarity with ICD-10-CM coding, HCC mappings, and risk score calculations. **Qualifications (Preferred)** **Preferred** + Medicare… more
    University of Utah Health (08/13/25)
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  • Medical Director

    Molina Healthcare (West Valley City, UT)
    …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare ,… more
    Molina Healthcare (08/20/25)
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  • AVP, Encounters

    Molina Healthcare (Orem, UT)
    …+ Extensive understanding of Medicare Advantage, ACA and Medicaid risk adjustment processes, including encounter data submission and deletion requirements ... **Job Description** **Job Summary** The AVP, Risk Adjustment Encounters is responsible for...processes that track, evaluate, and submit encounter deletions for Medicare Advantage, ACA, and Medicaid lines of business. This… more
    Molina Healthcare (08/22/25)
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  • Sr Compliance RCM & Coding Auditor

    Humana (Salt Lake City, UT)
    …analyze large data sets + Knowledge of healthcare compliance, mainly primary care and risk adjustment , pharmacy knowledge a plus + Certified Coder (CPC, CRC, ... to assess, investigate, audit and validate the mitigation of compliance risk across the organization. This team ensures that healthcare providers align… more
    Humana (08/23/25)
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