• Director, Risk Adjustment (Hybrid)

    CareFirst (Baltimore, MD)
    **Resp & Qualifications** **PURPOSE:** The Director, Risk Adjustment oversees the outcomes and operations of risk adjustment across the organization within ... Medicare Advantage, Medicaid & ACA markets. The Risk Adjustment Director is responsible for strategic direction, leadership, establishing and maturing key function,… more
    CareFirst (06/19/25)
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  • Director, Government Programs Risk…

    Blue KC (Kansas City, MO)
    …discount program** **Job Description Summary:** The Director, Government Programs Risk Adjustment & Audit assumes overall leadership of the risk adjusted revenue ... optimization strategy and oversight of Government Programs Risk Adjustment programs. **Job Description** + ​Interface with Blue KC operational and clinical… more
    Blue KC (06/18/25)
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  • Risk Adjustment Coding Coordinator I/II

    Excellus BlueCross BlueShield (Buffalo, NY)
    …you, we encourage you to apply! Job Description: Summary: The Risk Adjustment Coding Coordinator is responsible for various aspects of decision-making and ... to ensure accurate diagnosis coding. This position is responsible for risk adjustment coding and quality assurance validation for the following programs, including… more
    Excellus BlueCross BlueShield (05/20/25)
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  • Risk Adjustment Developer

    Commonwealth Care Alliance (Boston, MA)
    …of Encounter Data Management within the Revenue Cycle Department, the Risk Adjustment Data Developer is responsible for the design, development, and maintenance of ... systems and tools that support Commonwealth Care Alliance's (CCA) risk adjustment and Hierarchical Condition Category (HCC) revenue programs. This position ensures… more
    Commonwealth Care Alliance (06/25/25)
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  • Risk Adjustment Analyst - Mount Sinai…

    Mount Sinai Health System (New York, NY)
    **Job Description** MSHP seeks a Risk Adjustment Analyst support efforts to improve the overall quality and completeness of clinical documentation in outpatient ... experience ? At least 2 years of HCC Risk Adjustment experience, preferred ? Clinical background in a healthcare...books ? Familiarity and understanding of CMS HCC Risk Adjustment coding and data validation requirements ? Experience with… more
    Mount Sinai Health System (06/21/25)
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  • Product Manager, Risk Adjustment Analytics…

    Datavant (Lincoln, NE)
    …our bold vision for healthcare. **Role Overview** As a Product Manager, Risk Adjustment Analytics Products, you will contribute to the strategy and execution of ... analytics capabilities that power Datavant's risk adjustment solutions. You'll drive the development of robust, scalable,...+ Define and own the product vision for risk adjustment analytics across retrospective and prospective use cases. +… more
    Datavant (06/06/25)
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  • Risk Adjustment Specialist (Clinical)

    Centene Corporation (Harrisburg, PA)
    …of Pennsylvania **Position Purpose:** Support the development and maintenance of Risk Adjustment related programs and reporting. Aid in working with Risk ... Adjustment vendors for programs within all lines of business....Aid in the development and support of company-wide Risk Adjustment initiatives within all product lines and assist in… more
    Centene Corporation (06/04/25)
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  • HCC Risk Adjustment Coder

    MedKoder (Mandeville, LA)
    …schedule. Description: MedKoder, LLC is seeking a remote Professional HCC Risk Adjustment Coder who will apply both technical and specialized expertise to help ... while identifying opportunities for increased financial success. The HCC Risk Adjustment Coder provides coding services to health systems and insurance plans… more
    MedKoder (04/15/25)
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  • Risk Adjustment Business Analyst

    Commonwealth Care Alliance (Boston, MA)
    011260 CCA-Revenue Cycle Management Position Summary: The Risk Adjustment Business Analyst is responsible for understanding and interpreting complex programs, ... transformation methodology, and will play an essential role in driving Risk Adjustment (RA) Program performance. Supervision Exercised: * No, this position does not… more
    Commonwealth Care Alliance (05/23/25)
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  • Professional, Risk Adjustment Analyst

    MVP Health Care (Schenectady, NY)
    Professional, Risk Adjustment Analyst Headquarters Office, 625 State Street, Schenectady, New York, United States of America * Rochester Office, 20 S. Clinton Ave, ... and continuous improvement. To achieve this, we're looking for a **Professional, Risk Adjustment Analyst** to join #TeamMVP. This is the opportunity for you if you… more
    MVP Health Care (05/21/25)
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