• ACA / Medicare Risk…

    Baylor Scott & White Health (Boston, MA)
    + **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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  • Vice President, Risk Adjustment…

    Fallon Health (Worcester, MA)
    …Business, Healthcare, or Information Systems **Experience:** + 7-10+ years' experience in the risk adjustment and Medicare managed care environment + ... on Facebook, Twitter and LinkedIn. **Brief summary of purpose:** The Senior Director of Risk Adjustment is responsible for the execution and oversight of risk… more
    Fallon Health (09/19/25)
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  • Value-Based Reimbursement Specialist

    Highmark Health (Boston, MA)
    …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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