- Evolent (Albany, NY)
- …You'll Be Doing:** **Manager, Coding Support Specialist** Evolent Care Partners is seeking a Risk Adjustment Coding Support Manager to be a core member of the ... Risk Adjustment Coding Support team. Evolent Care Partners' mission is to partner directly with primary care organizations across the country to improve patient… more
- Ankura (New York, NY)
- …investigations, and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment . The Senior Director will also support practice ... of activities: + Help clients manage proactive and reactive Medicare and Commercial Risk Adjustment compliance, audit, and investigation projects for clients. +… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …right for you, we encourage you to apply! Job Description: Summary: The Risk Adjustment Coding Coordinator is responsible for various aspects of decision-making ... to ensure accurate diagnosis coding. This position is responsible for risk adjustment coding and quality assurance validation for the following programs,… more
- Elevance Health (Latham, NY)
- ** Risk Adjustment Actuarial Analyst II - Advanced Analytics** **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 ** Risk Adjustment Actuarial Analyst II - Advanced Analytics** is responsible for completing… more
- Molina Healthcare (NY)
- …role will be responsible for work around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling ... of complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data to evaluate healthcare intervention program performance.… more
- Molina Healthcare (NY)
- …DESCRIPTION** **Job Summary** Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintain risk ... identify risks. Additional leadership opportunities are available to lead national risk adjustment studies. Prior experience in Medicaid risk adjustment… more
- Datavant (Albany, NY)
- …vision for healthcare. **Role Overview** As the Director of Prospective + Concurrent Risk Adjustment Products, you will lead the strategy, roadmap, and execution ... on identifying and acting on undiagnosed conditions (prospective suspecting) and ensuring risk adjustment coding accuracy in near real-time (concurrent review).… more
- MVP Health Care (Rochester, NY)
- …and continuous improvement. To achieve this, we're looking for a **Professional, Sr. Risk Adjustment Analyst** to join #TeamMVP. This is the opportunity for ... at once while achieving desired results required + Knowledge of CMS risk adjustment and reinsurance payment processes and audits for Medicare and Commercial… more
- Molina Healthcare (Syracuse, NY)
- **JOB DESCRIPTION** **Job Summary** Responsible for Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and reporting. ... analyze impact. **KNOWLEDGE/SKILLS/ABILITIES** + Collaborate with Actuarial staff to calculate risk adjustment payment estimates. Document assumptions. + Analyze… more
- Datavant (Albany, NY)
- …to realize our bold vision for healthcare. **Role Overview** As a Product Manager, Risk Adjustment Coding Data Integration, you will own the data strategy and ... execution for Datavant's Retrospective Risk Adjustment Coding products, driving client data standardization, data integrations, database management, and… more