• Medicare Risk Adjustment

    Elevance Health (Waukesha, WI)
    ** Medicare Risk Adjustment Advanced Analytics Analyst** **On-Site Requirement: Hybrid 1;** **This role requires associates to be in-office 1 - 2 days per ... employment, unless an accommodation is granted as required by law._ The ** Medicare Risk Adjustment Advanced Analytics Analyst** is responsible for employing… more
    Elevance Health (07/29/25)
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  • Medicare Risk Adjustment

    Elevance Health (Waukesha, WI)
    ** Medicare Risk Adjustment Advanced Analytics Consultant** **On-Site Requirement: Hybrid 1;** **This role requires associates to be in-office 1 - 2 days per ... unless an accommodation is granted as required by law._ The ** Medicare Risk Adjustment Advanced Analytics Consultant** is responsible for employing… more
    Elevance Health (07/29/25)
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  • Senior Actuarial Analyst ( Medicare

    Molina Healthcare (Green Bay, WI)
    **JOB DESCRIPTION** **Job Summary** Responsible for Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and ... analyze impact. **KNOWLEDGE/SKILLS/ABILITIES** + Collaborate with Actuarial staff to calculate risk adjustment payment estimates. Document assumptions. + Analyze… more
    Molina Healthcare (07/25/25)
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  • Risk Adjustment Analyst - Predictive…

    Molina Healthcare (Madison, WI)
    …well as automated analytical as well as Reporting modules related to Risk Adjustment for Medicaid, Marketplace and Medicare /MMP. + Assist Risk ... **Job Description** **Job Summary** The Analyst, Risk Adjustment -Predictive Analytics role will support Molina's Risk Adjustment Predictive Analytics… more
    Molina Healthcare (07/31/25)
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  • Nurse Practitioner/Physician Assistant - MCW (Rock…

    Molina Healthcare (Janesville, WI)
    …plan products to coordinate a medical plan of care and capture diagnoses for Medicare risk adjustment . The NP/PA will utilize advanced assessment skills ... examination. + Capture and document annual diagnoses accurately consistent with Medicare risk adjustment . + Conduct comprehensive annual medication reviews… more
    Molina Healthcare (06/18/25)
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  • Senior Client Coding Project Manager

    Datavant (Madison, WI)
    …outpatient or inpatient setting. + Current CCS, CRC, or CPC required. + Previous Medicare Advantage Risk Adjustment , CDI, Medicaid, Commercial RA, and HEDIS ... up to date with current coding policies for ICD-10, Medicare Advantage, HHS (ACA), and other markets. + Provide...clients understand the shifts and trends happening in the risk adjustment coding space. **What you will… more
    Datavant (06/28/25)
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  • Risk Adjustment Revenue Director…

    Marshfield Clinic (Marshfield, WI)
    …to support the most exciting missions in the world!** **Job Title:** Risk Adjustment Revenue Director (Remote/Hybrid) **Cost Center:** 682891390 SHP-Strategic ... Shift:** 40 Normal (United States of America) **Job Description:** **JOB SUMMARY** The Risk Adjustment Revenue Director is a finance leader responsible for … more
    Marshfield Clinic (07/29/25)
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  • Senior Analyst, Healthcare Analytics ( Risk

    Molina Healthcare (Racine, WI)
    …role will be responsible for work around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling ... complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data to evaluate healthcare...risk models including the various CMS models for Medicare Advantage members, the HHS model for Commercial ACA… more
    Molina Healthcare (07/17/25)
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  • Product Manager, Risk Adjustment

    Datavant (Madison, WI)
    …to realize our bold vision for healthcare. **Role Overview** As a Product Manager, Risk Adjustment Analytics Products, you will contribute to the strategy and ... execution of analytics capabilities that power Datavant's risk adjustment solutions. You'll drive the development of robust, scalable, and actionable analytics… more
    Datavant (06/06/25)
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  • Auditor, Risk Adjustment (Remote)

    Molina Healthcare (Milwaukee, WI)
    …**Knowledge/Skills/Abilities** * Assist in the daily operations of all aspects of risk adjustment data validation related activities, including, but not limited ... retrieval, file transmissions, and adherence to applicable timelines * Support all risk adjustment audit related projects to ensure goals, objectives, milestones… more
    Molina Healthcare (07/25/25)
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