- 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
- Avera (Sioux Falls, SD)
- …Healthcare Effectiveness Data Information Sets (HEDIS). The Quality and Risk Adjustment Specialist will work closely with the Director of Quality and ... Risk Services, Manager of Risk Adjustment , Manager of Quality , Quality Coordinator - HEDIS, coder(s), claims staff, and primary care & specialty care… more
- Point32Health (Canton, MA)
- …business division goals. This position will report to the Director of Risk Adjustment Strategy, Operations and Quality Assurance. **Job Description** + ... of standard (and ad hoc) analyses to improve awareness and understanding of risk adjustment results and the quality , accuracy and identification of member… more
- Catholic Health Initiatives (Little Rock, AR)
- …for the value hub. + Through Risk Management/Auditor Manager, implements a risk adjustment coding department in appropriate Arkansas and Kentucky CIN. + ... to 25-50% professional travel may be involved. + Supports quality , clinical practice, safety, risk coding, compliance,...Health Management experience required + Must have experience with risk adjustment coding and value based reimbursement… more
- Molina Healthcare (MI)
- …Description** **Job Summary** The Director , Clinical Data Acquisition for Risk Adjustment , is responsible for the implementation, monitoring, and oversight ... of all chart collection for Risk Adjustment , RADV, or ...coding. This role also works with the Health Plan Risk / Quality leaders to strategically plan for supplemental… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …performing team responsible for maintaining, executing, and evaluating initiative impacts using the risk adjustment and quality analytics models across ACA ... of data submissions for ACA Commercial, Medicare, and Medicaid risk adjustment and quality programs....Education Required Required Skills and Experience * Accepting this director level position at BCBSMN requires signing an Employee… more
- Mount Sinai Health System (New York, NY)
- …CDQI, who will (1) be responsible for driving key population health goals including access, quality , utilization and accurate risk adjustment with a group of ... practices and (2) close partnership with the CDQI Director to drive accurate risk adjustment...hardwiring processes to drive excellence in efficiency of care, quality and accurate risk adjustment … more
- Centene Corporation (Jefferson City, MO)
- …and/or Healthcare Effectiveness Data and Information Set (HEDIS) performance + Responsible for quality improvement aspects of risk adjustment processes for ... **This is a remote opportunity with a preference or working EST/CST** ** Director will have oversight of Medical Record Retrieval- experience this area is… more
- MyFlorida (Tallahassee, FL)
- DIRECTOR - GAMES ADMINISTRATION - 36000865 Date: Dec 10, 2025 The State Personnel System is an E-Verify employer. For more information click on our E-Verify Website ... . Requisition No: 866609 Agency: Department of Lottery Working Title: DIRECTOR - GAMES ADMINISTRATION - 36000865 Pay Plan: Lottery Executive M… more
- CenterWell (Tallahassee, FL)
- …interrelate across the function or segment. **Strategy:** + In partnership with AVP, Risk Adjustment and AVP, MRA Strategy, responsible for driving ongoing ... caring community and help us put health first** The Director , Medical Coding extracts clinical information from a variety...Responsible for performance management and strategy development for PCO risk adjustment at the division and market… more