• Senior Risk Adjustment

    CareFirst (Baltimore, MD)
    **Resp & Qualifications** **PURPOSE:** The Senior ACA Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and integrity ... of key risk adjustment performance metrics through coordination of analytical processes, investigation and interpretation of HHS risk score methodology, … more
    CareFirst (09/26/25)
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  • ACA/Medicare Risk Adjustment

    Baylor Scott & White Health (Austin, TX)
    + **JOB SUMMARY** The Risk Adjustment Analyst Sr is responsible for monitoring and oversight of the end-to-end encounter management workflow. This position ... to provide insight to decision-makers. This role supports program management activities around risk adjustment data management and submissions to CMS. This role… more
    Baylor Scott & White Health (10/03/25)
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  • Senior Risk Adjustment

    CareFirst (Baltimore, MD)
    **Resp & Qualifications** **PURPOSE:** The Senior Risk Adjustment Business Operations Analyst assumes a pro-active approach in ensuring the accuracy and ... integrity of key risk adjustment performance metrics through coordination of analytical processes, investigation and interpretation of regulated markets risk more
    CareFirst (10/15/25)
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  • Senior Compliance Risk Adjustment

    Centene Corporation (Jefferson City, MO)
    …from home anywhere in the Continental United States.** **Position Purpose:** Supports the Risk Adjustment Compliance program elements, with a focus on the ... of compliance issues. Facilitates and leads external audits related to Risk Adjustment processes. Ensures visibility by way of reporting out audit deliverables… more
    Centene Corporation (10/29/25)
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  • Risk Adjustment Analyst -…

    UNC Health Care (Chapel Hill, NC)
    …the health and well-being of the unique communities we serve. Summary: The Risk Adjustment Coordinator will be responsible for analyzing and auditing medical ... by the third party payer under the value care contracts. In addition, the Risk Adjustment Coordinator will be responsible for working the EPIC WQ to reorder the… more
    UNC Health Care (10/30/25)
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  • Senior Risk Adjustment Coding…

    Centene Corporation (Jefferson City, MO)
    …the Continental United States. **Position Purpose:** Executes Line 2 oversight of Risk Adjustment activities, including monitoring, auditing, and supports Line 1 ... and complete diagnosis coding in alignment with HCCs and other risk adjustment models. Identifies and evaluates clinical documentation gaps, assesses risk more
    Centene Corporation (10/29/25)
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  • Risk Adjustment Coding Compliance…

    Centene Corporation (Jefferson City, MO)
    …the Continental United States. **Position Purpose:** Executes Line 2 oversight of Risk Adjustment activities, to include identifying compliance risks, auditing ... communicates findings to business stakeholders to ensure the quality of risk adjustment data. + Ensure coding accuracy by reviewing inpatient and outpatient… more
    Centene Corporation (10/29/25)
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  • Individual & Family Plans (IFP) Quality Review…

    The Cigna Group (Bloomfield, CT)
    The Risk Adjustment Quality & Review Analyst in IFP brings medical coding and Hierarchical Condition Category expertise to the role, evaluates complex ... Protocols and any additional applicable rule set. *Utilize HHS' Risk Adjustment Model to confirm accuracy of...needed. Education & Experience: The Quality Review & Audit Analyst will have a high school diploma and at… more
    The Cigna Group (11/13/25)
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  • Analyst , Actuarial (Medicaid Risk

    Molina Healthcare (Mesa, AZ)
    …DESCRIPTION** **Job Summary** Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintain risk ... identify risks. Additional leadership opportunities are available to lead national risk adjustment studies. Prior experience in Medicaid risk adjustment more
    Molina Healthcare (11/09/25)
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  • Workers' Compensation Risk Analyst

    Ventura County (Ventura, CA)
    Workers' Compensation Risk Analyst Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/5142408) Apply  Workers' Compensation Risk Analyst ... role of Risk Management within a county-wide environment. PAYROLL TITLE: Risk Analyst AGENCY/DEPARTMENT: County Executive Office/ Risk Management -… more
    Ventura County (11/15/25)
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