• Manager- Outpatient Clinical Documentation…

    Henry Ford Health System (Troy, MI)
    …appropriate clinical documentation, coding rules and regulations, HCC Coding and Risk Adjustment analysis and reimbursement guidelines. Actively works with ... organizational leadership to plan, design, test, implement, and evaluate integrated revenue cycle systems and solutions that support and enhance business practice, administrative and management needs. Facilitates and promotes standardization across Henry Ford… more
    Henry Ford Health System (12/11/25)
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  • Health Information Management Clerk II (Full-Time,…

    Queen's Health System (Honolulu, HI)
    …file transfer protocol (FTP) sites for quality and payor review of records (HEDIS/ Risk Adjustment /RAC). II. TYPICAL PHYSICAL DEMANDS: * Finger dexterity, seeing, ... hearing, speaking. * Occasional: Standing, sitting, walking, stooping, bending, squatting, and pushing/pulling up to 5 pounds of force. III. TYPICAL WORKING CONDITIONS: * Not substantially subjected to adverse environmental conditions. IV. MINIMUM… more
    Queen's Health System (12/09/25)
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  • Principal Data Scientist

    CVS Health (Hartford, CT)
    …**healthcare analytics** . + Proven expertise in **payer-side data** (claims, eligibility, risk adjustment ); provider-side experience is a plus. + Demonstrated ... success in **publishing research** or leading scientific studies. + **Technical Skills:** + Proficiency in Python, R, or similar languages; experience with big data platforms and cloud environments. + Strong knowledge of BI tools (Tableau, Power BI, Looker)… more
    CVS Health (12/09/25)
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  • Edits Coder

    University of Washington (Seattle, WA)
    …System (HCPCS) codes in Epic work queues (WQ) and/or Hierarchical Condition Category (HCC)/ Risk Adjustment Factor (RAF) and/or Care Gap review to ensure optimal ... reimbursement for facility and/or professional fee coding and billing for Clinic, Outpatient and related charges needing coding review in compliance with State and Federal guidelines. **PRIMARY JOB RESPONSIBILITIES** + Validates codes entered at the point of… more
    University of Washington (12/06/25)
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  • Senior Coder - RCO Coding

    UTMB Health (Galveston, TX)
    …Coder - Apprentice American Academy of Professional Coders (AAPC) Or CRC - Cert Risk Adjustment Coder American Academy of Professional Coders (AAPC) *One of the ... above certifications is required. **Job Summary/Description:** Properly codes and/or audits professional services for inpatient and/or professional and hospital outpatient technical services for multiple specialty areas to ensure accuracy and optimal… more
    UTMB Health (12/05/25)
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  • Head of Finance

    Robert Half Finance & Accounting (Portland, OR)
    …* Comprehensive knowledge of financial functions such as accounting, forecasting, and risk adjustment . * Strong understanding of healthcare systems, managed ... care, and relevant regulatory frameworks. * Exceptional leadership skills with the ability to drive organizational change and development. * Proficiency in negotiation, contractual execution, and aligning initiatives with corporate strategies. Robert Half is… more
    Robert Half Finance & Accounting (12/05/25)
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  • CRC Benefits - Benefits Sales Representative…

    CRC Insurance Services, Inc. (Melville, NY)
    …market our services. + Pre-screening level-funded groups to determine suitable products and risk adjustment factors on premium rates. + Driving agents to apply ... the appropriate technology solution as needed to assure safe, secure, and paperless sales administration. + Involving SE as appropriate with assistance in closing new cases and adding product lines. + Assisting agents/brokers in presenting our products to… more
    CRC Insurance Services, Inc. (12/04/25)
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  • Duals Performance Manager, Product strategy

    Point32Health (Canton, MA)
    …for key initiatives + Serve as the key liaison for Actuarial, Finance, Risk Adjustment , Corporate Data and Analytics, Medical Cost Management, and Pharmacy ... amongst others + Serve as liaison with key external vendors impacting product performance, eg, Cityblock + Build product competencies, in collaboration with the Policy and Strategy manager of Product Strategy to ensure analysis design, assessment and… more
    Point32Health (12/03/25)
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  • Actuarial Consultant

    BlueCross BlueShield of Tennessee (Chattanooga, TN)
    BCBST is seeking a detail\-oriented Actuarial Consultant to support our risk adjustment and value\-based team\. In this role, you will produce routine and ... ad\-hoc reports, as well as project financial accruals and assist with annual pricing responsibilities\. You'll be a great match for this role if you have at least two years of actuarial experience, preferably in the healthcare field\. Ideal candidates will… more
    BlueCross BlueShield of Tennessee (11/21/25)
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  • Certified Professional Medical Coder (Hybrid…

    Henry Ford Health System (Troy, MI)
    …billing and third-party payer regulations. + Knowledge of CMS programs, processes, risk adjustment payment methodology, and payment principles. + Knowledge of ... anatomy, physiology, pathophysiology, disease processes, medical terminology, pharmacology, and coding systems. + Experience with computer software programs such as Microsoft Office products, Adobe Pro, and others used for data collection. + Excellent… more
    Henry Ford Health System (11/14/25)
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