• Director Risk Adjustment

    Providence (Portland, OR)
    …of WA, OR and CA. **The Role:** As the Director of Risk Adjustment and Strategic Accounts at Providence Health Plan, you will be the cornerstone of our ... strategic vision. You will oversee risk adjustment programs, spearhead provider education, and...ideas to life. + **Advocacy & Impact:** Represent Providence Health Plan in advocacy, shaping the future of healthcare… more
    Providence (09/13/25)
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  • Vice President, Risk Adjustment

    Fallon Health (Worcester, MA)
    adjustment program operations, the Senior Director of Risk Adjustment Solutions will provide Fallon Health with leadership and expertise to execute ... Twitter and LinkedIn. **Brief summary of purpose:** The Senior Director of Risk Adjustment is... is responsible for the execution and oversight of risk adjustment services for Fallon Health more
    Fallon Health (09/19/25)
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  • Health Care Disputes - Compliance…

    Ankura (New York, NY)
    …operations, investigations, and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment . The Senior Director will also ... of activities: + Help clients manage proactive and reactive Medicare and Commercial Risk Adjustment compliance, audit, and investigation projects for clients. +… more
    Ankura (09/09/25)
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  • Director of Risk Adjustment

    Blue Cross and Blue Shield of Minnesota (Eagan, MN)
    …any legally protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Director of Risk Adjustment Location: Hybrid | Eagan, Minnesota ... Special Services/Product Lines The Impact You Will Have The Director of Risk Adjustment is...Collaborate with Clinical and Care Management teams to align risk adjustment initiatives with population health more
    Blue Cross and Blue Shield of Minnesota (09/10/25)
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  • Director , Prospective + Concurrent…

    Datavant (Augusta, ME)
    …for healthcare. **Role Overview** As the Director of Prospective + Concurrent Risk Adjustment Products, you will lead the strategy, roadmap, and execution ... on identifying and acting on undiagnosed conditions (prospective suspecting) and ensuring risk adjustment coding accuracy in near real-time (concurrent review).… more
    Datavant (08/08/25)
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  • Director Risk Adjustment

    Highmark Health (Pittsburgh, PA)
    …and Coding for the Highmark Health Enterprise. Ensures that Highmark's Risk Adjustment programs comply with all applicable guidelines, regulations and laws ... for Medicare and Medicaid Services (CMS), the Department of Health and Human Services (HHS), and others established at...a team of internal coder / clinicians that perform Risk Adjustment coding of medical records. Track… more
    Highmark Health (08/08/25)
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  • Risk Adjustment Analyst,…

    University of Utah Health (Murray, UT)
    …integrity, quality and trust that are integral to our mission. EO/AA_ + Risk Adjustment Analyst position provides support for our health plan's risk ... or related field. + 2+ years of experience in risk adjustment analytics within a health...sexual misconduct including sexual harassment, you may contact the Director /Title IX Coordinator in the Office of Equal Opportunity… more
    University of Utah Health (10/03/25)
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  • Manager, Risk Adjustment Coding…

    Evolent (Phoenix, AZ)
    …member contributes to providing better health outcomes for the population. The Risk Adjustment Coding Manager plays a crucial role in ensuring accurate ... health care providers on clinical documentation requirements, risk adjustment coding guidelines, and updates. +...coding questions and issues. + Collaborate with the coding director to develop policies, procedures, and workflows to enhance… more
    Evolent (09/23/25)
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  • Database Developer (Healthcare / Risk

    Commonwealth Care Alliance (Boston, MA)
    Director of Encounter Data Management within the Revenue Cycle Department, the Risk Adjustment Data Developer is responsible for the design, development, and ... of data systems and tools that support Commonwealth Care Alliance's (CCA) risk adjustment and Hierarchical Condition Category (HCC) revenue programs. This… more
    Commonwealth Care Alliance (09/24/25)
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  • Lead Data Analyst, Medicare Risk

    CareFirst (Baltimore, MD)
    … Analytics team is hiring a lead data analyst with deep experience in risk adjustment . This person will support the Director of Risk Adjustment by ... monitoring and reporting on risk adjustment KPIs, delivering insights for prospective and retrospective ...him/her ineligible to perform work directly or indirectly on health care programs. **PHYSICAL DEMANDS:** The associate is primarily… more
    CareFirst (08/19/25)
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