• Provider Reimbursement Adjustment

    UPMC (Pittsburgh, PA)
    UPMC Community Care Behavioral Health is hiring a full-time Provider Reimbursement Adjustment Coordinator to support the Provider Reimbursement team. Upon ... with Provider Relations Department including claims checks, technical questions, or adjustment requests. + Responsible for monitoring of assigned providers. +… more
    UPMC (04/18/25)
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  • Risk Adjustment Strategic Partner

    Intermountain Health (Murray, UT)
    …best practices related to population health management. + Manages vendor relationships that support risk adjustment activities. + Is accountable to Select Health ... **Job Description:** The Risk Adjustment Strategic Partner works as a liaison between...providers. This role will coordinate workstreams that include risk adjustment , HEDIS and STAR gap closure, and healthcare utilization.… more
    Intermountain Health (05/02/25)
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  • Sr Analyst, Healthcare Analytics - Risk…

    Molina Healthcare (Bowling Green, KY)
    …Analysis and forecasting of program value and underlying population trends in risk adjustment to provide analytic support for finance, pricing and actuarial ... will be responsible for work around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling of complex… more
    Molina Healthcare (05/03/25)
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  • Lead Data Analyst (Remote) - Medicare Risk…

    CareFirst (Baltimore, MD)
    … Analytics team is hiring a lead data analyst with deep experience in risk adjustment . This person will support the Director of Risk Adjustment by ... adjustment KPIs, delivering insights for prospective and retrospective risk adjustment operational decisions, and working independently to improve process and… more
    CareFirst (03/27/25)
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  • Manager Risk Adjustment Operations

    Premera Blue Cross (Mountlake Terrace, WA)
    …Board (SEBB) lines of business as well as all medical record retrieval for risk adjustment and some retrieval support for quality/HEDIS. As a key member of our ... systems and issuing direct letter requests to providers in support of Quality and Risk Adjustment initiatives. Join this mission driven and passionate team in… more
    Premera Blue Cross (04/11/25)
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  • VP Risk Adjustment Accuracy Management

    Highmark Health (Pittsburgh, PA)
    …to implement. + Develop, oversee and adapt infrastructure (processes, systems, talent) to support an effective risk adjustment program as CMS/HHS/DPW evolves the ... and Management: + Provide strategic leadership and management for the Risk Adjustment Accuracy Management Department. + Develop and oversee programs to ensure… more
    Highmark Health (04/30/25)
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  • Risk Adjustment Coding Manager

    CareOregon (Portland, OR)
    Job Title Risk Adjustment Coding Manager Requisition # 24887 Exemption Status Exempt Management Level Manager Direct Reports Coding Auditors Manager Title Director, ... Risk Adjustment Pay and Benefits Estimated hiring range $109,500 -...establish clinic and EMR workflows and education programs in support of coding accuracy and completeness initiatives. + Establish… more
    CareOregon (04/10/25)
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  • Manager of Quality - Risk Adjustment

    HCA Healthcare (Campbell, CA)
    …like family! Jump-start your career as a(an) Manager of Quality - Risk Adjustment Programs today with HCA Healthcare. **Benefits** HCA Healthcare, offers a total ... Plan with 10% off HCA Healthcare stock + Family support through fertility and family building benefits with Progyny...our team as a(an) Manager of Quality - Risk Adjustment Programs. We care for our community! Just last… more
    HCA Healthcare (02/22/25)
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  • Risk Adjustment Analyst

    CareOregon (Portland, OR)
    …Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Job Title Risk Adjustment Analyst Department Finance Exemption Status Exempt Requisition # 24959 Direct ... Reports N/A Manager Title Risk Adjustment Analytics Manager Pay & Benefits Estimated hiring range...company's data aggregator to produce reports and lists that support efforts to optimize risk scores. Analysis + Conduct… more
    CareOregon (05/03/25)
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  • Director for Quality and Risk Adjustment

    Robert Half Accountemps (Long Beach, CA)
    Description The Director for Quality and Risk Adjustment is responsible for leading enterprise development of the Medicare Star Ratings and Enterprise Risk ... Adjustment strategies that ensure our risk adjusted and Star...payment and risk sharing models, collaborative care models, data/analytics support , member engagement, health improvement and management programs and… more
    Robert Half Accountemps (04/04/25)
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