• Director Risk Adjustment

    Highmark Health (Pittsburgh, PA)
    …+ Production Coding : Manage a team of internal coder / clinicians that perform Risk Adjustment coding of medical records. Track production coding ... for the Highmark Health Enterprise. Ensures that Highmark's Risk Adjustment programs comply with all applicable...coding . Promotes the strategy and capabilities to develop risk management and physician / member initiatives that support… more
    Highmark Health (08/08/25)
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  • Manager, Risk Adjustment

    Evolent (Harrisburg, PA)
    …Be Doing:** **Manager, Coding Support Specialist** Evolent Care Partners is seeking a Risk Adjustment Coding Support Manager to be a core member of ... the Risk Adjustment Coding Support team....the Risk Adjustment Coding Support team. Evolent Care Partners'...coding questions and issues. + Collaborate with the coding director to develop policies, procedures, and… more
    Evolent (08/14/25)
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  • Director , Prospective + Concurrent…

    Datavant (Harrisburg, PA)
    …on identifying and acting on undiagnosed conditions (prospective suspecting) and ensuring risk adjustment coding accuracy in near real-time (concurrent ... As the Director of Prospective + Concurrent Risk Adjustment Products, you will lead the...technology solutions. + Solid understanding of clinical suspecting, concurrent coding workflows, risk adjustment models… more
    Datavant (08/08/25)
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  • Director of Client Success, Payer…

    Datavant (Harrisburg, PA)
    …strategic mindset and a focus on continuous improvement. + Familiarity with CMS HCC risk adjustment processes preferred \#LI-BC1 We are committed to building a ... experiences to realize our bold vision for healthcare. The Director of Client Success will report to the VP...departmental needs and organizational goals. + Partner with the coding operations, coding quality, data integration, product,… more
    Datavant (07/18/25)
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  • Ambulatory Coding and Doc Specialist

    Penn Medicine (Bala Cynwyd, PA)
    …of relevant coding medical professional services experience including ambulatory outpatient and risk adjustment coding . (Required) + Certified Risk ... Hospice- 150 Monument Road** **Hours: Full-Time** **Job Summary:** The Ambulatory Coding and Documentation Specialist reports to the Primary Care Service Line,… more
    Penn Medicine (08/07/25)
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  • Sr Compliance RCM & Coding Auditor

    Humana (Harrisburg, PA)
    …analyze large data sets + Knowledge of healthcare compliance, mainly primary care and risk adjustment , pharmacy knowledge a plus + Certified Coder (CPC, CRC, ... to assess, investigate, audit and validate the mitigation of compliance risk across the organization. This team ensures that healthcare providers align… more
    Humana (08/23/25)
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  • Compliance Analyst I

    Penn Medicine (Bala Cynwyd, PA)
    …unit, department, entity, and health system organization Credentials: + Certified Risk Adjustment Coder certification. (Preferred) + Certified Procedural Coder ... as triggered by any internal/external benchmarking identified by Senior leadership, Director and Associate Director . + Prepares materials, appropriate research… more
    Penn Medicine (08/08/25)
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  • Strategy Analyst

    Datavant (Harrisburg, PA)
    …and accountability for delivering results **Bonus Points If:** + You have experience in risk adjustment coding applications and technology \#LI-BC1 We are ... the Strategic Operations team and reports directly to the Director of Strategic Operations. As a trusted partner to...of Strategic Operations. As a trusted partner to the Risk Adjustment COO and broader leadership team,… more
    Datavant (08/14/25)
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