• ACA/ Medicare Risk Adjustment

    Baylor Scott & White Health (Albany, NY)
    …internal and external sources to provide insight to decision-makers. This role supports program management activities around risk adjustment data management ... + **JOB SUMMARY** The Risk Adjustment Analyst Sr is responsible...such as revenue forecasting and ROI. + Contributes to program improvement by designing and implementing business process and… more
    Baylor Scott & White Health (10/03/25)
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  • Risk Adjustment Actuarial Analyst II…

    Elevance Health (Latham, NY)
    …for completing projects and performing complex actuarial studies related to risk adjustment analytics in both the Medicaid and Medicare Advantage lines of ... to: + Analyzes and develops SAS and SQL programming to support Medicaid and Medicare Advantage risk adjustment initiatives. + Performs data mining and… more
    Elevance Health (09/30/25)
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  • Risk Adjustment Coding Coordinator…

    Excellus BlueCross BlueShield (Rochester, NY)
    …updates, maintaining currency in coding. Evaluates, researches, and recommends enhancements to the risk adjustment program . * Proposes and develops new desk ... right for you, we encourage you to apply! Job Description: Summary: The Risk Adjustment Coding Coordinator is responsible for various aspects of decision-making… more
    Excellus BlueCross BlueShield (08/27/25)
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  • Medical Director ( Medicare )

    Molina Healthcare (Rochester, NY)
    …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... and effective resource management. + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure a high quality… more
    Molina Healthcare (09/12/25)
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  • Informatics Manager - Healthcare

    CVS Health (NY)
    …Summary** CVS Health has an exciting opportunity for a Project Manager to join our Risk Adjustment Analytics team! In this role you will serve as a hybrid ... project manager and subject matter expert in Medicaid Risk Adjustment Medicaid analytics and reporting. You will be responsible for managing State risk more
    CVS Health (09/30/25)
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  • Registered Nurse 3 Infection Control, (NY Helps),…

    New York State Civil Service (Brooklyn, NY)
    …treatment teams to mitigate potential for infectious disease.* Developing infection control risk assessment and plan along with educational programs for staff and ... patients.* Evaluating the effectiveness of the infection control program and revising as needed.* Leading annual flu prevention, treatment, and reporting.*… more
    New York State Civil Service (07/15/25)
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  • Medical Director Physician Engagement and CDQI…

    Mount Sinai Health System (New York, NY)
    …for driving key population health goals including access, quality, utilization and accurate risk adjustment with a group of practices and (2) close partnership ... with the CDQI Director to drive accurate risk adjustment throughout the system. This Medical...all populations served, especially our patients covered under a Medicare arrangement (MSSP or MA). The MD will report… more
    Mount Sinai Health System (09/01/25)
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  • Licensed Mental Health Counselor (NY Helps),…

    New York State Civil Service (Bedford Hills, NY)
    …Provide direct mental health counseling and psychotherapeutic treatment* Conduct risk assessments, clinical evaluations, and intake screenings* Document and maintain ... the Hiring for Emergency Limited Placement - Statewide (HELPS) program as a Licensed Mental Health Counselor if they...Westchester County.This position is eligible for a Down State Adjustment of $4,000.Notes:1. If you fail to maintain your… more
    New York State Civil Service (10/07/25)
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  • Medical Director, Behavioral Health (TX/WA)

    Molina Healthcare (Yonkers, NY)
    …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... in line with industry standards and best practices * Assists with new program implementation and supports the health plan in-source BH services * Additional duties… more
    Molina Healthcare (09/13/25)
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  • Licensed Psychologist

    New York State Civil Service (NY)
    …and treatment, your duties may include: * Clinical leadership. * Program Management. * Psychological services requiring expertise in neuropsychology, child and ... treatment and expert testimony. * Specialized assessment (functional, personality, risk , competency, vocational, education) * Design and application of behavioral… more
    New York State Civil Service (07/15/25)
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