• UnitedHealth Group (Brooklyn, NY)
    …providers in understanding the Medicare quality program as well as CMS-HCC Risk Adjustment program as it relates to payment methodology and the importance ... programs focused on improving the quality of care for Medicare Advantage Members. Will be out in the field...coding Assist providers in understanding quality and CMS-HCC Risk Adjustment driven payment methodology and the… more
    Upward (07/04/25)
    - Related Jobs
  • Optum NV (Las Vegas, NV)
    …They will support the market oversight and direction of Outpatient Care Management Services, Medicare Risk Adjustment Factor (RAF) education as well as ... Medicare Advantage programs (STARS, RAF, HEDIS, CHAPS/HOS etc.) Experience with Medicare risk adjustment and presenting findings to client/providers… more
    Upward (07/14/25)
    - Related Jobs
  • Medicare Risk Adjustment

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    Ready to help us transform healthcare? Bring your true colors to blue. The Medicare Risk Adjustment Strategy Program Manager will report to the Senior ... Director of Medicare Risk Adjustment and Analytics....to ensure complete and accurate medical record documentation and coding . The Program Manager will contribute to the development… more
    Blue Cross Blue Shield of Massachusetts (06/27/25)
    - Related Jobs
  • Risk Adjustment Coding

    Trinity Health (Albany, NY)
    **Employment Type:** Full time **Shift:** Day Shift **Description:** Risk Adjustment Coding Specialist -St. Peter's Health Partners - Full-time - Remote ... **POSITION PURPOSE:** The Risk Adjustment Coding Specialist works...and MEAT (Monitored, Evaluated/Assessed/Addressed, Treated) standards while adhering to coding guidelines established by the Centers for Medicare more
    Trinity Health (07/02/25)
    - Related Jobs
  • Clinical Documentation Integrity Specialist…

    UCLA Health (Los Angeles, CA)
    … Advantage Risk Adjustment , you will be an expert in risk adjustment coding and documentation, working closely with physicians, IPA coders, ... Coding Specialist (CCS) certification, required + A Certified Risk Adjustment Coder (CRC), required + Reliable...understanding of ICD-10, CPT and CPT (II), and HCPCS coding systems required + Knowledge of Medicare more
    UCLA Health (05/16/25)
    - Related Jobs
  • Medicare Advantage Risk

    UCLA Health (Los Angeles, CA)
    …and others. + Serve as a key departmental resource for application use related to risk adjustment coding guidelines and gap closure reporting. Salary Range: ... Description As the Business Data Analyst for our Medicare Advantage Risk Adjustment team, you will be responsible for producing accurate and insightful… more
    UCLA Health (06/11/25)
    - Related Jobs
  • Director, Government Programs Risk

    Blue KC (Kansas City, MO)
    …documentation and quality coding . + ​Provide Government Programs oversight to ensure Medicare Advantage and ACA Risk Adjustment and state regulations are ... state and federal regulatory guidance for risk adjustment , audit and documentation and coding accuracy...+ ​Maintain expert knowledge of ACA risk adjustment regulations + ​Maintain expert knowledge of Medicare more
    Blue KC (06/18/25)
    - Related Jobs
  • Risk Adjustment Auditor Educator…

    Trinity Health (Syracuse, NY)
    …compliance standards in our provider group. **SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE:** Risk adjustment coding , provider auditing and clinical/education ... specialist with a solid background in value-based plans (VBP), Medicare Advantage (MA) and Medicare shared savings...and REQUIRED CERTIFICATION, EDUCATION, LICENSURE AND EXPERIENCE INCLUDES:** + Risk Adjustment Coding - Certified… more
    Trinity Health (07/18/25)
    - Related Jobs
  • Risk Adjustment Consultant

    Tufts Medicine (Burlington, MA)
    …Provides education and feedback to physicians on a regular basis in regard to Risk Adjustment Coding guidelines (HCC/DxCG), as well as ICD-10-CM Guidelines ... meets both established coding standards as well as CMS and Commercial Risk Adjustment guidelines. This position has extensive knowledge of overall ICD-10-CM … more
    Tufts Medicine (07/14/25)
    - Related Jobs
  • Director, Risk Adjustment

    Corewell Health (Grand Rapids, MI)
    …This position will evaluate and assess the organization's risk related to risk adjustment coding and conduct internal audits to improve compliance. ... risk adjustment exposure/ risk . Contributes to and approves Priority Health Risk Adjustment Coding Guidelines. + Serve as point person for… more
    Corewell Health (07/21/25)
    - Related Jobs