• Manager, Risk Adjustment Coding…

    Evolent (Helena, MT)
    …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
    Evolent (08/29/25)
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  • Director, Risk Adjustment (Hybrid)

    CareFirst (Baltimore, MD)
    …all lines of business. Drives member and provider intervention close Risk Adjustment gaps. Support the development and delivery of enterprise-wide training ... organization's goals. + Establish standards for and provide advisory support in the completion of Risk Adjustment processes, as well as govern, support , and… more
    CareFirst (06/19/25)
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  • Database Developer (Healthcare / Risk…

    Commonwealth Care Alliance (Boston, MA)
    …for the design, development, and maintenance of data systems and tools that support Commonwealth Care Alliance's (CCA) risk adjustment and Hierarchical Condition ... develop, and maintain automated data pipelines and systems to support risk adjustment and encounter data submissions (RAPS/EDPS). + Implement and optimize… more
    Commonwealth Care Alliance (06/25/25)
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  • Risk Adjustment Auditor Educator - St.…

    Trinity Health (Albany, NY)
    …with regulations as well as supporting SPHPMA, IHANY and Trinity Health's risk adjustment and payer value-based plan initiatives to support revenue and ... and accuracy of documentation and corresponding ICD-10-CM choices to support proper payment in the risk adjustment ...to support proper payment in the risk adjustment model in which the healthcare system participates. +… more
    Trinity Health (08/16/25)
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  • Risk Adjustment Analyst, Health Plans

    University of Utah Health (Murray, UT)
    …integrity, quality and trust that are integral to our mission. EO/AA_ + Risk Adjustment Analyst position provides support for our health plan's risk ... diagnose issues and test changes. + Participates in change management procedures to support accurate risk adjustment team documentation and process flows. +… more
    University of Utah Health (08/13/25)
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  • Senior Analyst, Healthcare Analytics (Risk…

    Molina Healthcare (NY)
    …Analysis and forecasting of program value and underlying population trends in risk adjustment to provide analytic support for finance, pricing and actuarial ... will be responsible for work around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling of complex… more
    Molina Healthcare (07/17/25)
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  • Senior Actuarial Analyst (Medicaid Risk…

    Molina Healthcare (Everett, WA)
    …and present findings to leadership + Generate and distribute routine reports to support risk adjustment calculations, pricing, and financial reporting + Identify ... Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintain risk adjustment model, estimate… more
    Molina Healthcare (08/08/25)
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  • Lead Data Analyst, Medicare Risk Adjustment

    CareFirst (Baltimore, MD)
    … Analytics team is hiring a lead data analyst with deep experience in risk adjustment . This person will support the Director of Risk Adjustment by ... adjustment KPIs, delivering insights for prospective and retrospective risk adjustment operational decisions, and working independently to improve process and… more
    CareFirst (08/19/25)
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  • Product Manager, Risk Adjustment Coding…

    Datavant (Providence, RI)
    …+ **Domain Expertise:** Well-versed in the key underlying healthcare data sources that support risk adjustment coding, including standards such as HL7, FHIR, CMS ... 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… more
    Datavant (08/20/25)
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  • Senior Actuarial Analyst (Medicare Risk…

    Molina Healthcare (Tampa, FL)
    …and maintain risk score models. + Generate and distribute routine reports to support risk adjustment calculations, pricing, and financial reporting. + Extract ... **JOB DESCRIPTION** **Job Summary** Responsible for Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and reporting.… more
    Molina Healthcare (07/25/25)
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