- Molina Healthcare (Jacksonville, FL)
- **Job Description** **Job Summary** The Senior Analyst will serve a key role on the RADV ( Risk Adjustment Data Validation) team, contributing to the ... required for audit response. + Collaborate with internal stakeholders-including IT, Risk Adjustment operations, clinical teams, and retrieval vendors-to ensure… more
- Molina Healthcare (Tampa, FL)
- …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
- Molina Healthcare (Tampa, FL)
- **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
- Molina Healthcare (St. Petersburg, FL)
- …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 (FL)
- …This Sr . Analyst , Healthcare Analytics role will support Molina's Risk Adjustment Analytics team. The job responsibilities include developing risk ... + Experience developing queries within project management tools like Azure DevOps. + Risk Adjustment experience and some familiarity with Power BI level report… more
- Centene Corporation (Tallahassee, FL)
- …from home anywhere in the Continental United States.** **Position Purpose:** Supports the Risk Adjustment Compliance program elements, with a focus on the ... of compliance issues. Facilitates and leads external audits related to Risk Adjustment processes. Ensures visibility by way of reporting out audit deliverables… more
- Molina Healthcare (St. Petersburg, FL)
- …Summary** The Junior Analyst will play a supporting role on the RADV ( Risk Adjustment Data Validation) team, assisting in the execution of CMS and internal ... and confirm required data elements. + Collaborate with internal teams-including IT, Risk Adjustment operations, and clinical teams-to ensure accurate and… more
- Citigroup (Tampa, FL)
- Wholesale Lending and Enterprise Data Business Execution Senior Analyst - Vice President - Hybrid The Business Execution Senior Analyst (Data Governance ... and implementation of the Enterprise and Wholesale Loans Data Governance Strategy, Data Risk and Control Framework, and plays a critical role in activities to… more
- Molina Healthcare (Orlando, FL)
- …directly with **clinicians, nurses, or case management teams** + Familiarity with risk adjustment , value-based care models, or healthcare performance metrics + ... **JOB DESCRIPTION** **Job Summary** JOB SUMMARY: The Sr . Analyst , Healthcare plays a critical role in supporting clinical and operational initiatives by… more
- Molina Healthcare (Jacksonville, FL)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing ... of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's),… more