• 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… more
    CareFirst (06/19/25)
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  • Director, Government Programs Risk

    Blue KC (Kansas City, MO)
    …**Employee 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… more
    Blue KC (06/18/25)
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  • Risk Adjustment Coding Coordinator…

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

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

    Datavant (Lincoln, NE)
    …to realize 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, and actionable analytics… more
    Datavant (06/06/25)
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  • Risk Adjustment Analyst - Mount…

    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 ... of 3 years coding experience ? At least 2 years of HCC Risk Adjustment experience, preferred ? Clinical background in a healthcare setting, preferred ?… more
    Mount Sinai Health System (06/21/25)
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  • Risk Adjustment Specialist…

    Centene Corporation (Harrisburg, PA)
    …the state 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...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… more
    Centene Corporation (06/04/25)
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  • HCC Risk Adjustment Coder

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

    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 ... 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… more
    MVP Health Care (05/21/25)
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  • VP Risk Adjustment Accuracy…

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