• Director, Quality and Risk Management…

    St. Luke's University Health Network (Orwigsburg, PA)
    …Certified Professional in Healthcare Quality (CPHQ) or Certified Professional in Healthcare Risk Management (CPHRM) or appropriate alternative within 2 years ... Quality and Patient Safety is responsible for all aspects of Quality, Clinical Risk Management and Patient Safety for their assigned entity. This individual will… more
    St. Luke's University Health Network (08/08/25)
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  • Senior Risk Partner Management

    Highmark Health (Pittsburgh, PA)
    …related field **EXPERIENCE** **Required** + 7 years in Compliance, Privacy, Government Affairs, Healthcare Operations, Risk , Audit, or legal functions + 5 years ... role **Preferred** + 10 years in Compliance, Privacy, Government Affairs, Healthcare Operations, Risk , Audit, or legal functions + 5 years in Healthcare… more
    Highmark Health (08/29/25)
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  • Manager, Risk Adjustment Coding Support

    Evolent (Harrisburg, PA)
    …team looking for dedicated team members with a passion for improving healthcare . **Collaboration Opportunities:** Our Risk Adjustment coding support team offers ... efficiently. + Compliance knowledge, understanding industry standards and regulations in healthcare coding, specifically Risk Adjustment and all HCC models… more
    Evolent (08/14/25)
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  • Director, Prospective + Concurrent Risk…

    Datavant (Harrisburg, PA)
    …Qualifications** **Required** + 8+ years of product management experience in healthcare , including ownership of clinical, risk adjustment, or provider-facing ... in health data exchange. Our vision is that every healthcare decision is powered by the right data, at...**Role Overview** As the Director of Prospective + Concurrent Risk Adjustment Products, you will lead the strategy, roadmap,… more
    Datavant (08/08/25)
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  • Director, Corporate Risk Mgmt

    UPMC (Pittsburgh, PA)
    …duties as assigned. + Juris doctor preferred or master's degree with concentration in healthcare . + Minimum of 5 years risk management experience. + Knowledge of ... Division Chief Legal Officer & VP Compliance, Quality and Risk Management and the Risk Management team...Federal and State regulations impacting healthcare . + The ability to prepare and critically analyze… more
    UPMC (08/19/25)
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  • Product Manager, Risk Adjustment Coding…

    Datavant (Harrisburg, PA)
    …of professional, educational and life experiences to realize our bold vision for healthcare . **Role Overview** As a Product Manager, Risk Adjustment Coding Data ... SDLC + **Domain Expertise:** Well-versed in the key underlying healthcare data sources that support risk adjustment...key underlying healthcare data sources that support risk adjustment coding, including standards such as HL7, FHIR,… more
    Datavant (08/20/25)
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  • Auditor, HCC Risk Adjustment Coding - Full…

    Datavant (Harrisburg, PA)
    …diversity of professional, educational and life experiences to realize our bold vision for healthcare . As an Auditor, HCC Risk Adjustment Coder, you will review ... in health data exchange. Our vision is that every healthcare decision is powered by the right data, at...standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a… more
    Datavant (08/08/25)
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  • Director, Data & AI Architecture

    NASCO (Harrisburg, PA)
    …and engineering teams to deliver data-driven SaaS solutions that enhance healthcare payer operations, risk management, and member engagement. ... SaaS products and platform models + Familiarity with US Healthcare payer analytics use cases (eg, risk ...US Healthcare payer analytics use cases (eg, risk stratification, claims analytics, provider network optimization) + Certifications… more
    NASCO (07/24/25)
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  • Regional Economic Manager - Mid Atlantic Region

    Medtronic (Philadelphia, PA)
    …for assigned regions. + Lead the execution and implementation of value based healthcare product and therapy risk share agreements, specifically focused on ... can begin a life-long career of exploration and innovation, while helping champion healthcare access and equity for all. You'll lead with purpose, breaking down… more
    Medtronic (08/09/25)
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  • Manager Risk & Compliance Management

    Highmark Health (Pittsburgh, PA)
    … or Healthcare related industry + 3 years overseeing privacy, risk , audit, and/or compliance teams **Preferred** + 3 years with contract negotiations **LICENSES ... :** **JOB SUMMARY** This job is responsible for the day-to-day direction of all risk and compliance assessment activities of Highmark Health across a broad range of… more
    Highmark Health (08/16/25)
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