• Risk Adjustment Analyst

    Fallon Health (Worcester, MA)
    …fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. **Brief summary of purpose:** The Risk Adjustment Analyst (RAA) will be a SME for the ... MassHealth risk adjustment model(s) and related data submission requirements. This role will be familiar with all revenue streams relevant to the product line(s)… more
    Fallon Health (09/06/25)
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  • Strategy Analyst

    Datavant (Boston, MA)
    …reports directly to the Director of Strategic Operations. As a trusted partner to the Risk Adjustment COO and broader leadership team, you'll play a key role in ... for delivering results **Bonus Points If:** + You have experience in risk adjustment coding applications and technology \#LI-BC1 We are committed to building a… more
    Datavant (08/14/25)
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  • Senior Network & Provider Analytics

    Point32Health (Canton, MA)
    …care claims data, coding schemes (ICD-9/ICD-10, CPT/HCPCS, DRGs), and health status risk adjustment . In-depth health care reimbursement and managed care business ... the Director or Senior Manager, the Senior Network Performance Analyst will be part of a team responsible for...and Reserving to ensure open communication relating to provider risk deals. + In-depth knowledge and understanding of managed… more
    Point32Health (08/07/25)
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  • Business Information Consultant Senior - Provider…

    Elevance Health (Woburn, MA)
    …of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), ... consolidating processes for forecast and month-end results. + Serve as an analyst and advisory to both internal and external stakeholders, developing value-based… more
    Elevance Health (08/26/25)
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