• 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 (Helena, MT)
    …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 (08/29/25)
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  • Director , Risk Adjustment

    Corewell Health (Grand Rapids, MI)
    Job Summary The Director Risk Adjustment Prospective...and assess the organization's risk related to risk adjustment coding and conduct ... adjustment exposure/ risk . Contributes to and approves Priority Health Risk Adjustment Coding Guidelines. + Serve as point person for relationships… more
    Corewell Health (07/21/25)
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  • Director of Risk Adjustment

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …to ensure data integrity, accuracy, completeness and adherence to leading practices in risk adjustment coding . * Identifies external partner opportunities, ... Blue Cross and Blue Shield of Minnesota Position Title: Director of Risk Adjustment Location:...* Responsible for developing and implementing risk adjustment strategies to facilitate accurate and complete coding more
    Blue Cross and Blue Shield of Minnesota (09/10/25)
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  • Director , Prospective + Concurrent…

    Datavant (Augusta, ME)
    …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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  • Health Care Disputes - Compliance Risk

    Ankura (New York, NY)
    Risk Adjustment data collection and submission activities as well as knowledge of Risk Adjustment coding requirements preferably with a Risk ... and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment . The Senior Director will also support practice… more
    Ankura (09/09/25)
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  • Director , Registered Nurse/Certified…

    Ankura (New York, NY)
    …college/university + Current Registered Nurse license + Experience working for payors conducting risk adjustment reviews + Clinical experience in a variety of ... and mature their compliance programs, conduct program effectiveness reviews, and risk assessments, and perform compliance audits. We assist in-house and outside… more
    Ankura (09/09/25)
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  • Director of Client Success, Payer…

    Datavant (Olympia, WA)
    …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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  • Risk Adjustment Analyst, Health…

    University of Utah Health (Murray, UT)
    …clinical, coding , and IT teams to ensure compliance, optimize risk adjustment revenue, and help drive provider engagement interventions. **Qualifications** ... trust that are integral to our mission. EO/AA_ + Risk Adjustment Analyst position provides support for...(eg, SAS, Python, R, Excel). + Familiarity with ICD-10-CM coding , HCC mappings, and risk score calculations.… more
    University of Utah Health (08/13/25)
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  • Director of Professional Services…

    Hartford HealthCare (Farmington, CT)
    …Knowledge of ICD 10 Diagnostic and CPT coding regulations and guidelines and risk adjustment coding * Extensive knowledge of state, federal and Medicare ... Heart and Vascular, Orthopedics and Tallwood Urology & Kidney. Position Summary: The Director of Professional Services Coding will provide system wide leadership… more
    Hartford HealthCare (07/22/25)
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