• Medicare Risk Adjustment

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    Ready to help us transform healthcare? Bring your true colors to blue. The Medicare Risk Adjustment Strategy Program Manager will report to the Senior ... Director of Medicare Risk Adjustment and Analytics....Director of Medicare Risk Adjustment and Analytics. This role will... performance that will assess the progress of the risk adjustment strategy + Develop… more
    Blue Cross Blue Shield of Massachusetts (06/27/25)
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  • Associate Director, Risk Adjustment

    Blue Cross Blue Shield of Massachusetts (Boston, MA)
    …The role is responsible for the strategy , execution and performance of Medicare risk adjustment reporting and analytics, infrastructure and systems to ... Bring your true colors to blue. Under the direction of the Senior Director of Medicare Risk Adjustment and Analytics, the Associate Director of Risk more
    Blue Cross Blue Shield of Massachusetts (06/27/25)
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  • Director, Government Programs Risk

    Blue KC (Kansas City, MO)
    … adjusted revenue optimization strategy and oversight of Government Programs Risk Adjustment programs. **Job Description** + ​Interface with Blue KC ... and quality coding. + ​Provide Government Programs oversight to ensure Medicare Advantage and ACA Risk Adjustment and state regulations are maintained. +… more
    Blue KC (06/18/25)
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  • VP Risk Adjustment Accuracy…

    Highmark Health (Pittsburgh, PA)
    …At least five years' direct management experience Preferred: + 5 or more years' Medicare and/or Commercial risk adjustment experience + Previous involvement ... financial returns in a fully compliant manner. Develop a Risk Management governance strategy for the Enterprise...Management: + Provide strategic leadership and management for the Risk Adjustment Accuracy Management Department. + Develop… more
    Highmark Health (04/30/25)
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  • Director, Risk Adjustment (Hybrid)

    CareFirst (Baltimore, MD)
    …are: direct and indirect reports and vendors. Prioritize work in alignment with Risk Adjustment strategy , business goals, organizational strategies and ... oversees the outcomes and operations of risk adjustment across the organization within Medicare Advantage, Medicaid & ACA markets. The Risk more
    CareFirst (06/19/25)
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  • Product Manager, Risk Adjustment

    Datavant (Lincoln, NE)
    …to realize our bold vision for healthcare. **Role Overview** As a Product Manager, Risk Adjustment Analytics Products, you will contribute to the strategy ... and execution of analytics capabilities that power Datavant's risk adjustment solutions. You'll drive the development of robust, scalable, and actionable… more
    Datavant (06/06/25)
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  • Manager, Risk Adjustment Analytics

    Datavant (Little Rock, AR)
    …and managing in a remote environment (2+ years) + 3+ years of experience working with Medicare , ACA, and/or Medicaid risk adjustment models + 5+ years of ... vision for healthcare. **What we're looking for:** The incoming Risk Adjustment Analytics Manager will be stepping...with other managers and the department director to set strategy and mobilize the team to be as performant… more
    Datavant (06/12/25)
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  • Director of Actuarial and Risk

    Marshfield Clinic (Marshfield, WI)
    …exciting missions in the world!** **Job Title:** Director of Actuarial and Risk Adjustment Services **Cost Center:** 682891378 SHP-Actuarial **Scheduled Weekly ... **Job Description:** **JOB SUMMARY** The Director of Actuarial & Risk Adjustment Services is a key leader...Chief Actuary to lead unit development and execution of strategy through tactics, actions, processes, plans, and analytical tools… more
    Marshfield Clinic (06/29/25)
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  • Risk Adjustment Performance…

    Humana (Frankfort, KY)
    …+ Experience in healthcare operations, preferably with exposure to MRA or risk adjustment + Strong understanding of financial concepts (budgeting, ROI, ... + Support strategic roadmap development in collaboration with Kourtney and the Strategy Advisor + **Reporting & Analysis** + Support with the development of… more
    Humana (07/11/25)
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  • Manager, Provider Engagement - VBP…

    Centene Corporation (Queens, NY)
    …+ Develop and refine Medicare contract models to incorporate RAF ( Risk Adjustment Factor) trends, Stars quality metrics, and benchmarking methodologies to ... execution of the organization's Value-Based Payment strategies (VBP) and other risk -based contracting strategies. + Oversee Medicare -specific VBP contracts,… more
    Centene Corporation (07/09/25)
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