• Risk Adjustment Business Analyst

    Commonwealth Care Alliance (Boston, MA)
    …from management. * Working knowledge of the provider-based healthcare industry and Risk Adjustment preferred . Required Language (must have): * English EEO is The ... 011260 CCA-Revenue Cycle Management Position Summary: The Risk Adjustment Business Analyst is responsible for understanding and interpreting complex programs,… more
    Commonwealth Care Alliance (05/23/25)
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  • Risk Adjustment Analyst - Mount Sinai…

    Mount Sinai Health System (New York, NY)
    …Minimum of 3 years coding experience ? At least 2 years of HCC Risk Adjustment experience, preferred ? Clinical background in a healthcare setting, preferred ... **Job Description** MSHP seeks a Risk Adjustment Analyst support efforts to improve the overall...? Credentials in one or more of the following, preferred : ? Certified Professional Medical Auditor (CPMA) ? Certified… more
    Mount Sinai Health System (06/21/25)
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  • Risk Adjustment Analyst

    Fallon Health (Worcester, MA)
    …the provider-based healthcare industry, claims processing, provider billing or Risk Adjustment strongly preferred + Familiarity with MassHealth/Medicaid a plus ... and LinkedIn. **Brief Summary of Purpose** : The Risk Adjustment Analyst (RAA) will be a SME for the...(RAA) will be a SME for the MassHealth risk adjustment model(s) and related data submission requirements. This role… more
    Fallon Health (06/09/25)
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  • Risk Adjustment Specialist (Clinical)

    Centene Corporation (Harrisburg, PA)
    …required. Bachelor's degree in nursing and experience in managed care industry preferred . Risk adjustment and Microsoft Excel experience preferred . ... of Pennsylvania **Position Purpose:** Support the development and maintenance of Risk Adjustment related programs and reporting. Aid in working with Risk … more
    Centene Corporation (06/04/25)
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  • Risk Adjustment Developer

    Commonwealth Care Alliance (Boston, MA)
    …including claims, encounters, diagnoses, and provider data. + Familiarity with CMS risk adjustment methodologies and HCC coding preferred . + Experience with data ... of Encounter Data Management within the Revenue Cycle Department, the Risk Adjustment Data Developer is responsible for the design, development, and maintenance of… more
    Commonwealth Care Alliance (06/25/25)
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  • Risk Adjustmt Coder Educator / Clinical…

    Hartford HealthCare (Hartford, CT)
    …strongly desired. * Experience with the nuances of diagnosis coding and risk adjustment programs preferred * Progressively responsible role with leadership * ... - Physician (CCS-P) or Certified Coding Specialist (CCS) Certified Risk Adjustment Coder (CRC) preferred (required within 6 months of hire) _We take great care… more
    Hartford HealthCare (06/12/25)
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  • Senior Department Coordinator, Risk…

    Premera Blue Cross (Mountlake Terrace, WA)
    …(Required) + Experience working in a similar type of department (Risk Adjustment , Quality) or comparable work environment (Healthcare). ( Preferred ) + Has ... blog: https://healthsource.premera.com/ . **_About the role of Senior Risk Adjustment Operations Department Coordinator_** As the **Senior Risk Adjustment more
    Premera Blue Cross (06/21/25)
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  • HIM Audit and Education Specialist

    Hartford HealthCare (Farmington, CT)
    …Hartford Healthcare o Experience with the nuances of diagnosis coding and risk adjustment programs preferred ** o Experience working in an educational/ training ... specialist will support documentation practices that comply with CMS risk adjustment program requirements and ICD 10 coding guidelines. Reporting to Manager… more
    Hartford HealthCare (04/24/25)
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  • Analyst, Data Analytics

    Convey Health Solutions (Chicago, IL)
    …Familiarity with healthcare payer/provider claims, clinical, or quality data. + Risk Adjustment experience is preferred . OTHER DUTIES AND RESPONSIBILITIES + ... to accelerate analytic insights and new feature enhancements to Pareto's risk adjustment solution suite. Additionally, the ability to understand / contribute to… more
    Convey Health Solutions (05/30/25)
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  • Senior Risk & Quality Performance Manager (Remote)

    Molina Healthcare (Caldwell, ID)
    …NPIs, TINs, etc. * History of success in roles impacting both Risk Adjustment and HEDIS ** PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** PMP, Six Sigma Green ... ABILITIES:** * 4+ years of program and/or project management experience in risk adjustment and/or quality * 4+ years of experience supporting HEDIS engine activity,… more
    Molina Healthcare (06/26/25)
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