- Evolent (Austin, TX)
- …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
- Molina Healthcare (Austin, TX)
- …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 (TX)
- …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 (Austin, TX)
- …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
- Molina Healthcare (Fort Worth, TX)
- …+ Provides training and education to network of providers on how to improve their risk adjustment knowledge as well as provide coding updates related to Risk ... in related field **Preferred Experience** + Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model + Background in supporting risk … more
- Molina Healthcare (San Antonio, TX)
- …**Knowledge/Skills/Abilities** * Assist in the daily operations of all aspects of risk adjustment data validation related activities, including, but not limited ... file transmissions, and adherence to applicable timelines * Support all risk adjustment audit related projects to ensure goals, objectives, milestones and… more
- Molina Healthcare (Austin, TX)
- **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
- Centene Corporation (Austin, TX)
- …and management of department overseeing compliance with regulations and laws related to Risk Adjustment across our Marketplace, Medicaid and Medicare lines of ... assessments oversight and the monitoring work plans pertaining to Risk Adjustment . Partners with business areas to ensure and implement effective prevention,… more
- Datavant (Austin, TX)
- …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
- Molina Healthcare (Fort Worth, TX)
- …monitoring, and oversight of all chart collection for HEDIS, or HEDIS-like projects, Risk Adjustment , Risk Adjustment Data Validation, and ... measures that support business objectives. + HEDIS Operations experience. + Risk Adjustment and Data Validation experience. + Chart Collection audit experience.… more