• Risk Adjustment Analyst

    Martin's Point Health Care (Portland, ME)
    …has been certified as a "Great Place to Work" since 2015. Position Summary The Risk Adjustment Analyst provides analytic, technical, and decision support to ... timely, and consistent information enabling informed decisions related to risk adjustment activities. The Analyst ...of third-party analytical tools and reporting platforms related to risk profile analysis and HCC coding +… more
    Martin's Point Health Care (07/12/25)
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  • Senior, Compliance Risk Adjustment

    Centene Corporation (Tallahassee, FL)
    risk adjustment and/or compliance required + Previous experience in risk adjustment oversight and/or coding planning preferred + Demonstrated ... from home anywhere in the Continental United States.** **Position Purpose:** Supports the Risk Adjustment Compliance program elements, with a focus on the… more
    Centene Corporation (07/31/25)
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  • Medicare Advantage Risk Adjustment

    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: ... As the Business Data Analyst for our Medicare Advantage Risk Adjustment team, you will be responsible for producing accurate and insightful department… more
    UCLA Health (06/11/25)
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  • Manager Risk Adjustment Analytics

    Corewell Health (Grand Rapids, MI)
    …Some states are not eligible for remote work (CA and NY). Positioned in the Risk Adjustment Department, the Manager, Risk Adjustment Analytics will ... be responsible for leading the Risk Adjustment Analytics team and supporting the goals and objectives...who is adept at problem solving, possesses strong SQL coding skills and an ability to communicate effectively to… more
    Corewell Health (07/24/25)
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  • Risk Revenue Analyst - Senior

    Independent Health (Buffalo, NY)
    …on pricing outcomes. + Establish and implement claims review processes to support risk adjustment . Analyze data and provide strategic insights to enhance pricing ... and financial performance. + Ensure compliance with CMS regulations and risk adjustment methodologies. + Develop and execute pricing strategies, incorporating… more
    Independent Health (08/08/25)
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  • Quality Senior Analyst

    CVS Health (Montgomery, AL)
    …Coder) **or** CCS-P (Certified Coding Specialist-Physician) and CRC (Certified Risk Adjustment Coder) required. + CPMA (Certified Professional Medical ... Coder) or CCS-P (Certified Coding Specialist-Physician) and CRC (Certified Risk Adjustment Coder) required. + CPMA (Certified Professional Medical Auditor)… more
    CVS Health (08/08/25)
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  • Data Operations Analyst

    MedKoder (Mandeville, LA)
    coding veteran, the company offers services including inpatient and outpatient facility coding , medical risk adjustment management, DRG coding ... About Us MedKoder, LLC is a full-service medical coding management services provider based in Mandeville, Louisiana, specializing in expert medical coding for… more
    MedKoder (07/29/25)
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  • Compliance Analyst I

    Penn Medicine (Bala Cynwyd, PA)
    …unit, department, entity, and health system organization Credentials: + Certified Risk Adjustment Coder certification. (Preferred) + Certified Procedural Coder ... Monument Road, Bala Cynwyd, PA Summary: + The Compliance Analyst (CA) I is responsible for audits, reviews, and...guidance/response that is congruent with standards of CMS, Correct Coding guidelines as well as National Correct Coding more
    Penn Medicine (08/08/25)
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  • Medical Economics Analyst Sr - Hybrid

    AdventHealth (Maitland, FL)
    …in understanding professional and facility claims and managed care concepts such as risk adjustment , capitation, FFS, DRG, APG, APCs and other payment mechanisms ... (Altamonte Springs, FL)** **The role you'll contribute:** A Senior Medical Economics analyst is responsible for analyzing and evaluating financial and economic data… more
    AdventHealth (08/08/25)
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  • Sr. Provider Reimbursement Analyst

    Point32Health (Canton, MA)
    …claims data, coding schemes (ICD-9/ICD-10, CPT/HCPCS, DRGs), and health status risk adjustment . In-depth health care reimbursement and managed care business ... direction of the Director or Senior Manager, the Senior Analyst will be part of a team responsible for...ad hoc requests. The Senior Network & Provider Analytics Analyst may also serve as a project manager and/or… more
    Point32Health (08/07/25)
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