- Monogram Health (Fort Myers, FL)
- …HEDIS, Medicaid, Medicare , quality improvement, medical utilization management, and risk adjustment Current state medical license without restrictions to ... each state within the market Experience with high need Medicare Advantage and managed Medicaid populations Experience with NCQA,...practice and free of sanctions from Medicaid or Medicare . Willingness to become licensed in multiple states. MD… more
- Elevance Health (Tampa, FL)
- …for completing projects and performing complex actuarial studies related to risk adjustment analytics in both the Medicaid and Medicare Advantage lines of ... Analyzes and develops SAS and SQL programming to support Medicaid and Medicare Advantage risk adjustment initiatives. + Performs data mining and data-driven… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …company seeks a highly skilled and results-driven Senior Product Manager to lead our Medicare Advantage Risk Adjustment solution portfolio. In this critical ... will drive the strategic planning, development, and optimization of our Medicare Advantage Risk Adjustment solution, ensuring that our deliverables support… more
- Humana (Fort Lauderdale, FL)
- …+ Experience with public speaking and presentation skills with healthcare providers + Medicare Risk Adjustment knowledge **Additional Information** Work at ... 4 or more years of medical coding experience + Risk Adjustment knowledge + Proficiency with data...recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over 23 years.… more
- CVS Health (Tallahassee, FL)
- …auditing. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories CRC (HCC)CPMA (Certified ... ICD-10 codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of... and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and… more
- CVS Health (Tallahassee, FL)
- …required. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) preferred. ... ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of... and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and… more
- Amazon (FL)
- …deadline: Jan 8, 2026 As a Program Manager II on the One Medical At - Risk team, you will be the primary builder of new and existing capabilities and programs ... aimed at improving health outcomes for our at- risk patient populations. Working within Amazon's mission to be...have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support… more
- ChenMed (Miami, FL)
- …+ Comprehensive knowledge of Medicare program including but not limited to Risk Adjustment processes and Fee For Service. + Knowledge of applicable federal, ... incumbent also serves as a subject matter expert on risk - adjustment and medical economics to aid in...business acumen and acuity + In depth knowledge of Medicare , Medicaid, and commercial billing rules and regulations, coding,… more
- Deloitte (Jacksonville, FL)
- …care and fee-for-service, Medicaid policy, budget forecasting and fiscal analyses, and risk adjustment + Support business development efforts for Federal and ... waivers (ie, 1115, 1915 b/c, 1332) + Experience with risk adjustment mechanisms + Experience with Provider...individual medical and small group markets + Experience with Medicare products, including Medicare Advantage or … more
- Molina Healthcare (Jacksonville, FL)
- …with setting annual targets for each VBP/VBC in conjunction with national quality and risk adjustment VPs, Regional Directors of Quality/ Risk , Director of ... revenue management, strategy, and compliance + Knowledge of value based programs, risk adjustment models, quality metrics such as HEDIS and STARS, knowledge… more
