• Risk Adjustment QA Consultant

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …a focus on Medicare Advantage and ACA risk adjustment . * Certified Risk Adjustment Coder (CRC) certification * In-depth knowledge of ACA & Medicare ... Blue Cross and Blue Shield of Minnesota Position Title: Risk Adjustment QA Consultant Location: Hybrid |...CMS RADV audits, including retrieval and coding of targeted medical records. * Design and implement QA programs to… more
    Blue Cross and Blue Shield of Minnesota (09/10/25)
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  • Health Care Disputes - Compliance Risk

    Ankura (New York, NY)
    …as knowledge of Risk Adjustment coding requirements preferably with a Risk Adjustment Coder certification. For individuals assigned and/or hired to ... investigations, and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment . The Senior Director will also support practice… more
    Ankura (09/09/25)
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  • Director Risk Adjustment - Health…

    Providence (Portland, OR)
    …specifically, plus 5 years of progressive management experience. + **Certification:** Certified Risk Adjustment Coder (CRC) is preferred. + **Skills ... OR and CA. **The Role:** As the Director of Risk Adjustment and Strategic Accounts at Providence...401(k) Savings Plan with employer matching, health care benefits ( medical , dental, vision), life insurance, disability insurance, time off… more
    Providence (09/13/25)
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  • Quality & Risk Adjustment Provider…

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …or leadership-facing experience * Knowledge of Health Care Quality measures * Certified Risk Adjustment Coder (CRC via AAPC) or Certified Professional ... and Blue Shield of Minnesota Position Title: Quality & Risk Adjustment Provider Consultant Location: Hybrid |...offer a comprehensive benefits package which may include: * Medical , dental, and vision insurance * Life insurance *… more
    Blue Cross and Blue Shield of Minnesota (09/30/25)
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  • Auditor, HCC Risk Adjustment Coding…

    Datavant (Denver, CO)
    …experiences to realize our bold vision for healthcare. As an Auditor, HCC Risk Adjustment Coder , you will review medical records to identify and code ... using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical… more
    Datavant (08/08/25)
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  • Risk Score Accuracy (RSA) Program Manager…

    Bon Secours Mercy Health (Cincinnati, OH)
    …Identifies opportunities for performance improvement related to system-wide HCC and other risk adjustment coding initiatives. Conducts medical record reviews ... RSA initiatives, including Hierarchical Condition Categories (HCC) coding and other risk adjustment payment models. This role strategizes and collaborates… more
    Bon Secours Mercy Health (10/04/25)
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  • Senior Coding Educator

    Humana (Helena, MT)
    …to adapt quickly to change **Preferred Qualifications** + Bachelor's Degree + Certified Risk Adjustment Coder (CRC) + Certified Documentation Expert ... improvement opportunities and give guidance around operational and clinical best practices in the risk adjustment methodology. This role reports to the Risk more
    Humana (10/14/25)
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  • Individual & Family Plans (IFP) Quality Review…

    The Cigna Group (Bloomfield, CT)
    …Information Technician (RHIT) + Registered Health Information Administrator (RHIA) + Certified Risk Adjustment Coder (CRC) certification Individuals who have ... The Risk Adjustment Quality & Review Analyst in IFP brings medical coding and Hierarchical Condition Category expertise to the role, evaluates complex … more
    The Cigna Group (10/16/25)
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  • Lead - CDI Specialist

    Mayo Clinic (Rochester, MN)
    …AHIMA certification OR Certified Inpatient Coder (CIC) AAPC certification Certified Risk Adjustment Coder (CRC) AAPC certification **Exemption Status** ... CDI!** Join our team to train providers on documentation best practices and risk adjustment , deliver tailored education, and develop engaging content across Mayo… more
    Mayo Clinic (09/05/25)
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  • Coding Data Quality Auditor

    CVS Health (Helena, MT)
    …(Certified Professional Coder ) or CCS-P (Certified Coding Specialist-Physician). + CRC (Certified Risk Adjustment Coder ) must be able to obtain within 1 ... Summary** Responsible for performing quality inter-rater review audits of medical records coded by internal team (CDQA and Sr...Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and… more
    CVS Health (10/16/25)
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