• Director, Risk Adjustment Prospective…

    Corewell Health (Grand Rapids, MI)
    …and/or Certification in area of specialty - UNKNOWN Unknown CRC, AAPC Certified Risk Adjustment Coder preferred Physical Demands + Pallet to Waist (6" from ... Job Summary The Director Risk Adjustment Prospective Operations & Risk Mitigation is the...finance, accounting or business management or related field. + Preferred Master's Degree in a related field of study.… more
    Corewell Health (07/21/25)
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  • Risk Adjustment Consultant

    Tufts Medicine (Burlington, MA)
    …Coder (CPC). 2. Two (2) years of outpatient billing, coding, and risk adjustment experience, . ** Preferred Qualifications:** 1. Associate's degree. 2. Certified ... **Job Overview** Under the director of the Director, Risk Adjustment Operations, performs accurate and timely reviews and validations...Risk Adjustment Coder (CRC) highly preferred . 3. Two (2) years of outpatient billing, coding,… more
    Tufts Medicine (07/14/25)
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  • Director of Client Success, Payer Risk…

    Datavant (Honolulu, HI)
    …mindset and a focus on continuous improvement. + Familiarity with CMS HCC risk adjustment processes preferred \#LI-BC1 We are committed to building a diverse ... in Business, Operations Management, or a related field; MBA or equivalent advanced degree preferred . + At least 8 to 10 years of experience in healthcare technology… more
    Datavant (07/18/25)
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  • Manager Risk Adjustment Analytics

    Corewell Health (Grand Rapids, MI)
    …analyst in the health insurance industry + 5 years of relevant experience in Risk Adjustment Analytical role Preferred + 2 years of relevant experience in a ... for remote work (CA and NY). Positioned in the Risk Adjustment Department, the Manager, Risk Adjustment Analytics will be responsible for leading the Risk … more
    Corewell Health (07/24/25)
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  • Risk Adjustment Revenue Director…

    Marshfield Clinic (Marshfield, WI)
    …and/or American Academy of Professional Coders - Certified Risk Adjustment Coder certification. ** Preferred /Optional:** None **Marshfield Clinic Health ... most exciting missions in the world!** **Job Title:** Risk Adjustment Revenue Director (Remote/Hybrid) **Cost Center:** 682891390 SHP-Strategic Finance **Scheduled… more
    Marshfield Clinic (07/29/25)
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  • Senior, Compliance Risk Adjustment Analyst

    Centene Corporation (Tallahassee, FL)
    adjustment and/or compliance required + Previous experience in risk adjustment oversight and/or coding planning preferred + Demonstrated understanding of ... risk adjustment regulatory landscape preferred + Risk Adjustment regulatory audit experience preferred + Medicare experience preferred Pay Range:… more
    Centene Corporation (07/31/25)
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  • Database Developer (Healthcare / Risk…

    Commonwealth Care Alliance (Boston, MA)
    …including claims, encounters, diagnoses, and provider data. + Familiarity with CMS risk adjustment methodologies and HCC coding preferred . + Experience with data ... of Encounter Data Management within the Revenue Cycle Department, the Risk Adjustment Data Developer is responsible for the design, development, and maintenance of… more
    Commonwealth Care Alliance (06/25/25)
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  • Risk Adjustmt Coder Educator / Clinical…

    Hartford HealthCare (Hartford, CT)
    …strongly desired. * Experience with the nuances of diagnosis coding and risk adjustment programs preferred * Progressively responsible role with leadership * ... - Physician (CCS-P) or Certified Coding Specialist (CCS) Certified Risk Adjustment Coder (CRC) preferred (required within 6 months of hire) _We take great care… more
    Hartford HealthCare (06/12/25)
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  • Director Risk Adjustment , Coding & Quality

    Highmark Health (Pittsburgh, PA)
    …**LICENSES AND CERTIFICATIONS** **Required** + AAPC, Certified Professional Coder (CPC) ** Preferred ** + AAPC, Certified Risk Adjustment Coder (CRC) **SKILLS** ... Coding for the Highmark Health Enterprise. Ensures that Highmark's Risk Adjustment programs comply with all applicable guidelines, regulations and laws established… more
    Highmark Health (08/08/25)
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  • Clinical Quality Consultant NP 100% Virtual,…

    Elevance Health (Miami, FL)
    …. ** Preferred Skills, Capabilities and Experiences:** + **AAPC Certified Risk Adjustment Coder preferred .** + Expert level knowledge of ICD-10 CM, CMS ... guidelines including Risk Adjustment payment model, STARS and HEDIS highly preferred . + Clinical review experience. Please be advised that Elevance Health only… more
    Elevance Health (08/08/25)
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