• Director , Risk Adjustment

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

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …transform healthcare? Bring your true colors to blue. Under the direction of the Senior Director of Medicare Risk Adjustment and Analytics, the Associate ... Director of Risk Adjustment Data and Analytics is responsible for developing and executing the analytic plan for the Medicare and Merged Market segments. The… more
    Blue Cross Blue Shield of Massachusetts (06/27/25)
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  • Director , Government Programs Risk

    Blue KC (Kansas City, MO)
    …with adoption financial assistance** **Employee discount program** **Job Description Summary:** The Director , Government Programs Risk Adjustment & Audit ... risk adjusted revenue optimization strategy and oversight of Government Programs Risk Adjustment programs. **Job Description** + ​Interface with Blue KC… more
    Blue KC (06/18/25)
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  • Director of Actuarial and Risk

    Marshfield Clinic (Marshfield, WI)
    …come together to support the most exciting missions in the world!** **Job Title:** Director of Actuarial and Risk Adjustment Services **Cost Center:** ... 5:00 pm (United States of America) **Job Description:** **JOB SUMMARY** The Director of Actuarial & Risk Adjustment Services is a key leader for commercial… more
    Marshfield Clinic (06/29/25)
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  • Senior Director , Risk

    Centene Corporation (Austin, TX)
    …and management of department overseeing compliance with regulations and laws related to Risk Adjustment across our Marketplace, Medicaid and Medicare lines of ... assessments oversight and the monitoring work plans pertaining to Risk Adjustment . Partners with business areas to ensure and implement effective prevention,… more
    Centene Corporation (07/04/25)
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  • Risk Adjustment Consultant

    Tufts Medicine (Burlington, MA)
    …as other technical requirements. 4. Summarizes and interprets audit findings for Director Risk Adjustment Operations/NEQCA Leadership; tracks audit results ... over time, identifies trends, and recommends corrective actions. 5. Collaborates with Director Risk Adjustment Operations/NEQCA staff and vendors to identify… more
    Tufts Medicine (07/14/25)
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  • Medicare Risk Adjustment Strategy…

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …Medicare Risk Adjustment Strategy Program Manager will report to the Senior Director of Medicare Risk Adjustment and Analytics. This role will manage ... the process of developing and maintaining the risk adjustment strategic plan. This position will track and monitor the key performance indicators of multi-year… more
    Blue Cross Blue Shield of Massachusetts (06/27/25)
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  • Director of Client Success, Payer…

    Datavant (Honolulu, HI)
    …strategic mindset and a focus on continuous improvement. + Familiarity with CMS HCC risk adjustment processes preferred \#LI-BC1 We are committed to building a ... professional, educational and life experiences to realize our bold vision for healthcare. The Director of Client Success will report to the VP of Client Success and… more
    Datavant (07/18/25)
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  • Medical Director Physician Engagement…

    Mount Sinai Health System (New York, NY)
    adjustment with a group of practices and (2) close partnership with the CDQI Director to drive accurate risk adjustment throughout the system. This ... the status quo **Role Summary:** MSHP seeks a Medical Director (MD), Physician Engagement and CDQI, who will (1)...drive excellence in efficiency of care, quality and accurate risk adjustment for all populations served, especially… more
    Mount Sinai Health System (06/03/25)
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  • Program Manager- Population Health & Value-Based…

    Henry Ford Health System (Troy, MI)
    …Cycle processes within value-based reimbursement models and initiatives. Reporting to the Director , Risk Adjustment and Value-Based Payment, the Program ... Manager is responsible for complex program management, strategic planning, and process improvement activities. The leader acts with a high degree of autonomy focusing on improving Revenue Cycle processes, Population Health program management, Accountable Care… more
    Henry Ford Health System (06/24/25)
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