• Senior Director , Risk…

    Centene Corporation (Austin, TX)
    …and management of department overseeing compliance with regulations and laws related to Risk Adjustment across our Marketplace, Medicaid and Medicare lines of ... assessments oversight and the monitoring work plans pertaining to Risk Adjustment . Partners with business areas to ensure and implement effective prevention,… more
    Centene Corporation (07/04/25)
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  • Director of Client Success, Payer…

    Datavant (Austin, TX)
    …strategic mindset and a focus on continuous improvement. + Familiarity with CMS HCC risk adjustment processes preferred \#LI-BC1 We are committed to building a ... professional, educational and life experiences to realize our bold vision for healthcare. The Director of Client Success will report to the VP of Client Success and… more
    Datavant (07/18/25)
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  • Associate Medical Director - Dallas

    CenterWell (Arlington, TX)
    …(clinical, financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and clinical ... and help us put health first** The Associate Medical Director (AMD) is an instrumental clinical leader of our...coaching initiatives are precise + Identify critical issues for high- risk patients during case reviews & other forums, and… more
    CenterWell (07/18/25)
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  • Director , Data & AI Architecture

    NASCO (Austin, TX)
    …deployment of AI/ML (Machine Learning) and agentic models for payer analytics, risk adjustment , fraud detection, and personalized member engagement + ... **Overview** Under general direction, the Director of Data and AI Architecture will drive the evolution of our hybrid data strategy and AI architecture to enhance… more
    NASCO (07/24/25)
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  • Medical Director (Marketplace)

    Molina Healthcare (San Antonio, TX)
    …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to...including: + 2 years previous experience as a Medical Director in a clinical practice. + Current clinical knowledge.… more
    Molina Healthcare (06/29/25)
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  • Director , Healthcare Analytics

    Centene Corporation (Austin, TX)
    …preferred. Familiarity with claims payment, utilization management, provider/vendor contracts, risk adjustment for government sponsored healthcare desired. ... a fresh perspective on workplace flexibility. **Position Purpose:** The Director , Healthcare Analytics leads analytic service delivery by aligning strategic… more
    Centene Corporation (08/03/25)
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  • Product Director - Pricing

    RELX INC (Houston, TX)
    …link at: https://www.icis.com/explore . About the Role ICIS is seeking an exceptional Director of Product Management to lead its Insight & Hindsight portfolios - the ... influence business outcomes through innovative product development and go-to-market execution. As Director , you will own the commercial roadmap for both the Insight… more
    RELX INC (07/08/25)
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  • Lead Director , Medicare Actuarial…

    CVS Health (Austin, TX)
    …regulatory compliance. + Serve as a subject matter expert on CMS regulations, risk adjustment , and revenue optimization. + Collaborate with internal stakeholders ... CMS Part C/D operations. + 5+ years' experience working with CMS regulations, risk adjustment methodologies, and revenue management. + 5+ years' experience… more
    CVS Health (07/01/25)
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  • Market Planning Director - Global Identity…

    RELX INC (Houston, TX)
    About the Business LexisNexis Risk Solutions is the essential partner in the assessment of risk . Within our Business Services vertical, we offer a multitude of ... Laundering/Counter Terrorist Financing, Identity Authentication & Verification, Fraud and Credit Risk mitigation and Customer Data Management. You can learn more… more
    RELX INC (06/07/25)
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  • Director , Applications (AI/Azure…

    Molina Healthcare (Fort Worth, TX)
    …applications -_** **which underpin essential business functions such as HEDIS reporting, Risk Adjustment (RA), and Health Plan Reporting.** + **_Azure ... Databricks._** + **_Python._** + **_Spark._** + **_QNXT._** **Preferred License, Certification, Association** Microsoft Technology, Mobility, ITIL To all current Molina employees: If you are interested in applying for this position, please apply through the… more
    Molina Healthcare (06/29/25)
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