- Baylor Scott & White Health (Austin, TX)
- + **JOB SUMMARY** The Risk Adjustment Analyst Sr is responsible for monitoring and oversight of the end-to-end encounter management workflow. This position ... to provide insight to decision-makers. This role supports program management activities around risk adjustment data management and submissions to CMS. This role… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …be considered. * Experience in medical coding with a focus on Medicare Advantage and ACA risk adjustment . * Certified Risk Adjustment Coder (CRC) ... certification * In-depth knowledge of ACA & Medicare Advantage risk adjustment methodology, coding guidelines (ICD-10-CM), healthcare compliance, and… more
- Blue KC (Kansas City, MO)
- …of that data. **Job Description** + Maintains expert knowledge of Medicare Advantage & ACA Risk Adjustment models + Responsible for all formal risk ... of the role + Minimum 5 years' experience in Medicare Advantage & ACA Risk Adjustment submission experience **Blue Cross and Blue Shield of Kansas City… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Medicare Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and ... integrity of key risk adjustment performance metrics through coordination of...and MS Access Database. + Experience with EDGE & ACA or Medicaid risk score methodology, including… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …bid development and financial forecasting. * Tracks and evaluates risk adjustment initiatives performance across Medicare , ACA , and Medicaid throughout ... Cross and Blue Shield of Minnesota Position Title: Director Risk Adjustment and Quality Analytics - Actuarial...Performs risk score computation and forecasting for Medicare , ACA , and Medicaid. * Oversees diagnostic… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …skills, and military experience will be considered. * Extensive knowledge of CMS risk adjustment regulations, HHS ACA requirements, Medicaid risk ... characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Director of Risk Adjustment Location: Hybrid | Eagan, Minnesota Career Area: Special… more
- CareFirst (Baltimore, MD)
- …to ensure that all risk adjustment activities fully comply with Medicare , Medicaid, ACA , and state-specific regulations. Remain current on changes to ... **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Operations Supervisor supports...supports the execution of the corporate coding strategy across Medicare Advantage, Medicaid, and ACA markets. This… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Manager plays a critical role in the development and execution of the corporate risk adjustment ... the end to end strategy by applying improvements and driving cost-effective risk adjustment actions across all organizational populations and products.… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Risk Adjustment Business Operations Analyst assumes a pro-active approach in ensuring the accuracy and ... integrity of key risk adjustment performance metrics through coordination of...and problem resolution to meet business operational requirements for Medicare Advantage(MA), Affordable Care Act ( ACA ) &… more
- CVS Health (Raleigh, NC)
- …+ **2+ years Government Programs experience including Medicare ,** **Commercial ACA , and/or Medicaid** + ** Risk adjustment working knowledge ... maintaining robust data pipelines that power reporting and analytics for risk adjustment and provider performance projects. You'll work closely with analysts,… more