• Risk Adjustment Compliance

    Humana (Tallahassee, FL)
    **Become a part of our caring community and help us put health first** The Risk Adjustment Compliance Professional 2 supports the organization's ... guidance, and sound judgement in determining appropriate actions within established framework. The Risk Adjustment Compliance Professional 2 contributes… more
    Humana (05/22/25)
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  • Manager Strategic Risk Adjustment

    Highmark Health (Tallahassee, FL)
    …This job provides end-to-end management, delivery and support to new and existing Risk Adjustment Programs. The incumbent will deliver value to the Health ... business outcomes and achieve strategic objectives relative to new and existing Risk Adjustment Programs. Supports other key objectives designed to… more
    Highmark Health (03/06/25)
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  • HCC Risk Adjustment Coder PRN PPC

    Datavant (Tallahassee, FL)
    …using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical ... complex problems with technology-forward solutions. Datavanters bring a diversity of professional , educational and life experiences to realize our bold vision for… more
    Datavant (03/27/25)
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  • Senior Delivery Consultant - Security, Risk

    Amazon (Miami, FL)
    …field, or equivalent experience - 3+ year(s) of experience in IT security, compliance , or risk management - Experience in technology automation, implementation, ... Description The Amazon Web Services Professional Services (ProServe) team is seeking a skilled...scripting (eg Terraform, Python) - Knowledge of security and compliance standards (eg HIPAA, GDPR) - Strong communication skills… more
    Amazon (05/13/25)
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  • Risk Manager, Logistics Claims Management

    Amazon (FL)
    …use cases. Amazon's Logistics Claims Management team is seeking a talented claims professional to support our rapidly growing and evolving global auto program. You ... for handling new issues that arise in a business-centric way while addressing risk . Typical transactions will range from standard claims settlement to complex high… more
    Amazon (04/12/25)
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  • Senior Financial Analytics Professional

    Humana (Tallahassee, FL)
    …and Medicaid regulations and payment models, monitors and reports on risk adjustment data submissions, and supports HQRI operations. **Responsibilities** ... factors **Preferred Qualifications** + Experience in Medicare Advantage - risk adjustment or Stars + Degree in...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
    Humana (05/14/25)
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  • Sr Manager, Business Intelligence

    CVS Health (Tallahassee, FL)
    …Sr Manager, within the Revenue Integrity organization, you will be leading Risk Adjustment technical activities not limited to, reconciliation and aggregation, ... external consultants, team members and/or matrixed staff as required to support MA Risk Adjustment Revenue Integrity initiatives. + Responsible for leading the… more
    CVS Health (05/21/25)
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  • Market Planning Consultant

    RELX INC (Boca Raton, FL)
    …matter expertise for Transaction Monitoring (TM) initiatives across the Financial Crimes Compliance (FCC) division of LexisNexis Risk Solutions. In this role, ... About the Business LexisNexis Risk Solutions is the essential partner in the...all functions including product, technology, data operations, marketing, and professional services to ensure an end-to-end focus for data,… more
    RELX INC (05/07/25)
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  • Market Partnership and Finance Strategy Lead - MRA

    CenterWell (Tallahassee, FL)
    …efficiencies, processes, education, and compliance as it relates to Medicare Risk Adjustment . Uses data-based insight to direct process improvement efforts ... and Finance Strategy Lead - MRA in the PCO risk adjustment area implements and supports strategy...we allow employees to invest in their personal and professional well-being, all from day one. ​ **Equal Opportunity… more
    CenterWell (04/26/25)
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  • Principle FedRAMP Continuous Monitoring Engineer

    RELX INC (Boca Raton, FL)
    …Continuous Monitoring Engineer Are looking for an opportunity to drive our FedRAMP compliance initiatives? Are you looking to become our FedRAMP SME? About the ... BusinessLexisNexis(R) Risk Solutions provides customers with solutions and decision tools...NIST guidelines. You will be to ensure the ongoing compliance of our organization's systems and infrastructure with FedRAMP… more
    RELX INC (05/07/25)
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