• Lead Data Analyst, Medicare Risk

    CareFirst (Baltimore, MD)
    …leadership roles. + Experience in healthcare industry and deep understanding of Medicare risk adjustment (clinical,submission cycle, and financial ... the organization in making better business decisions. The Quality, Stars, and Risk Adjustment Analytics team is hiring a lead data analyst with deep experience… more
    CareFirst (08/19/25)
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  • Senior Actuarial Analyst ( Medicare

    Molina Healthcare (Tampa, FL)
    **JOB DESCRIPTION** **Job Summary** Responsible for Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and ... analyze impact. **KNOWLEDGE/SKILLS/ABILITIES** + Collaborate with Actuarial staff to calculate risk adjustment payment estimates. Document assumptions. + Analyze… more
    Molina Healthcare (07/25/25)
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  • Medicare Risk Adjustment

    Elevance Health (Grand Prairie, TX)
    ** Medicare Risk Adjustment Advanced Analyst Senior** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration ... dynamic and adaptable workplace. Alternate locations may be considered. The ** Medicare Risk Adjustment Advanced Analyst Senior** is responsible for creating… more
    Elevance Health (08/16/25)
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  • Medicare Advantage Risk

    UCLA Health (Los Angeles, CA)
    Description As the Business Data Analyst for our Medicare Advantage Risk Adjustment team, you will be responsible for producing accurate and insightful ... Serve as a key departmental resource for application use related to risk adjustment coding guidelines and gap closure reporting. Salary Range: $78,500 -… more
    UCLA Health (06/11/25)
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  • Certified Risk Adjustment

    Redeemer Health Home Care & Hospice (Huntingdon Valley, PA)
    …Graduate. Certified coder CPC or CCS-P, and AAPC CRC certification. 2+ years coding, Medicare Risk Adjustment / Medicare Advantage and/or clinical. Plans ... and supporting clinical care plans to Risk Adjustment Data Validation (RADV) Timelines. Medicare and...Risk Adjustment Data Validation (RADV) Timelines. Medicare and Medicaid regulations and billing guidelines and AMA's… more
    Redeemer Health Home Care & Hospice (08/13/25)
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  • Database Developer (Healthcare / Risk

    Commonwealth Care Alliance (Boston, MA)
    …skills in SQL, data integration, and systems development are essential. Knowledge of Medicare risk adjustment methodologies is highly desirable. The ideal ... data ecosystem. + Support audit readiness and regulatory compliance for Medicare and Medicaid risk adjustment programs. + Represent the Risk more
    Commonwealth Care Alliance (06/25/25)
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  • Risk Adjustment Coding Specialist

    AdventHealth (Altamonte Springs, FL)
    …Monday-Friday **Shift** : 7:00AM-5:00PM **Location:** Remote **The role you'll contribute:** The Medicare Risk Adjustment Coding Specialist coordinates and ... adjustment and medical record review. + Experience with Medicare risk adjustment , Hierarchical Condition Categories (HCC), coding, billing, auditing and… more
    AdventHealth (08/26/25)
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  • VP Risk Adjustment Accuracy…

    Highmark Health (Blue Bell, PA)
    …At least five years' direct management experience Preferred: + 5 or more years' Medicare and/or Commercial risk adjustment experience + Previous involvement ... Development and Management: + Provide strategic leadership and management for the Risk Adjustment Accuracy Management Department. + Develop and oversee programs… more
    Highmark Health (07/30/25)
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  • Manager, Risk Adjustment

    Centene Corporation (Annapolis, MD)
    …data analysis/reporting experience in the healthcare industry. Previous managed care or Medicare experience preferred. Risk adjustment experience strongly ... on workplace flexibility. **Position Purpose:** Manage the business processes related to risk adjustment and quality improvement across Centene's for assigned… more
    Centene Corporation (08/30/25)
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  • Risk Adjustmt Coder Educator / Clinical…

    Hartford HealthCare (Hartford, CT)
    …in a variety of settings 3. Identify process improvements to capture data for Medicare Risk Adjustment 4. Builds relationships, programs, and processes ... recognition programs and other common practices across the system. *JOB SUMMARY:* The Risk Adjustment Coder Educator develops and implements an enterprise-wide … more
    Hartford HealthCare (06/12/25)
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