• Senior Network Performance Professional

    Humana (Little Rock, AR)
    …Health Care/Administration, RN or a related field + Experience with Medicare Risk Adjustment and/or medical coding + Proven organizational and ... advance their goals related to interoperability, quality, value-based arrangements, and risk adjustment strategies. Recommend execution strategies and monitor… more
    Humana (08/08/25)
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  • Medicare Risk Adjustment

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    Ready to help us transform healthcare? Bring your true colors to blue. The Medicare Risk Adjustment Strategy Program Manager will report to the Senior ... Director of Medicare Risk Adjustment and Analytics....to ensure complete and accurate medical record documentation and coding . The Program Manager will contribute to the development… more
    Blue Cross Blue Shield of Massachusetts (06/27/25)
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  • Risk Adjustment Coding

    Excellus BlueCross BlueShield (Rochester, NY)
    …see is right for you, we encourage you to apply! Job Description: Summary: The Risk Adjustment Coding Coordinator is responsible for various aspects of ... diagnosis coding . This position is responsible for risk adjustment coding and quality...Medicare Advantage and Commercial Hierarchical Condition Category (HCC) coding , and Medicaid Clinical Risk Groups (CRGs)… more
    Excellus BlueCross BlueShield (08/08/25)
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  • Risk Adjustment Coding

    Trinity Health (Albany, NY)
    **Employment Type:** Full time **Shift:** Day Shift **Description:** Risk Adjustment Coding Specialist -St. Peter's Health Partners - Full-time - Remote ... **POSITION PURPOSE:** The Risk Adjustment Coding Specialist works...and MEAT (Monitored, Evaluated/Assessed/Addressed, Treated) standards while adhering to coding guidelines established by the Centers for Medicare more
    Trinity Health (07/31/25)
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  • Clinical Documentation Integrity Specialist…

    UCLA Health (Los Angeles, CA)
    … Advantage Risk Adjustment , you will be an expert in risk adjustment coding and documentation, working closely with physicians, IPA coders, ... Coding Specialist (CCS) certification, required + A Certified Risk Adjustment Coder (CRC), required + Reliable...understanding of ICD-10, CPT and CPT (II), and HCPCS coding systems required + Knowledge of Medicare more
    UCLA Health (05/16/25)
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  • Director Risk Adjustment

    Highmark Health (Pittsburgh, PA)
    …+ Production Coding : Manage a team of internal coder / clinicians that perform Risk Adjustment coding of medical records. Track production coding ... for the Highmark Health Enterprise. Ensures that Highmark's Risk Adjustment programs comply with all applicable...coding . Promotes the strategy and capabilities to develop risk management and physician / member initiatives that support… more
    Highmark Health (08/08/25)
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  • Medicare Advantage Risk

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

    Datavant (Honolulu, HI)
    …and life experiences to realize our bold vision for healthcare. As an Auditor, HCC Risk Adjustment Coder, you will review medical records to identify and code ... standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will...in ICD-10 coding . + Experienced in HCC coding across Medicare , commercial, and Medicaid sectors.… more
    Datavant (08/08/25)
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  • Risk Adjustment Auditor Educator…

    Trinity Health (Syracuse, NY)
    …compliance standards in our provider group. **SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE:** Risk adjustment coding , provider auditing and clinical/education ... specialist with a solid background in value-based plans (VBP), Medicare Advantage (MA) and Medicare shared savings...and REQUIRED CERTIFICATION, EDUCATION, LICENSURE AND EXPERIENCE INCLUDES:** + Risk Adjustment Coding - Certified… more
    Trinity Health (07/18/25)
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  • Risk Adjustment Consultant

    Tufts Medicine (Burlington, MA)
    …Provides education and feedback to physicians on a regular basis in regard to Risk Adjustment Coding guidelines (HCC/DxCG), as well as ICD-10-CM Guidelines ... meets both established coding standards as well as CMS and Commercial Risk Adjustment guidelines. This position has extensive knowledge of overall ICD-10-CM … more
    Tufts Medicine (07/14/25)
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