• ACA / Medicare Risk

    Baylor Scott & White Health (Tallahassee, FL)
    + **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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  • AVP, Encounters

    Molina Healthcare (Jacksonville, FL)
    …Director level role or above. + Extensive understanding of Medicare Advantage, ACA and Medicaid risk adjustment processes, including encounter data ... **Job Description** **Job Summary** The AVP, Risk Adjustment Encounters is responsible for...processes that track, evaluate, and submit encounter deletions for Medicare Advantage, ACA , and Medicaid lines of… more
    Molina Healthcare (08/22/25)
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  • Value-Based Reimbursement Specialist

    Highmark Health (Tallahassee, FL)
    …in the organization's value-based reimbursement programs. Strong knowledge of risk adjustment methodologies and reporting/regulatory requirements and CMS ... share models and will be implemented for the Organization's Medicare Advantage, Medicaid, ACA , and commercial populations...outcomes strategic plan development. + 1 year experience with Medicare STARS, Medicaid HEDIS, risk revenue value… more
    Highmark Health (08/20/25)
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