- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior ACA Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and integrity ... of key risk adjustment performance metrics through coordination of analytical processes, investigation and interpretation of HHS risk score methodology, … more
- MVP Health Care (Schenectady, NY)
- …requires innovative thinking and continuous improvement. To achieve this, we're looking for a ** Risk Adjustment Analyst ** to join #TeamMVP. This is the ... prospective and retrospective objectives in population health management including focus on Risk Adjustment efforts. + Design targeting based upon disparate data… more
- Baylor Scott & White Health (Austin, TX)
- + **JOB SUMMARY** The Risk Adjustment Analyst Sr is responsible for monitoring and oversight of the end-to-end encounter management workflow. This position ... to provide insight to decision-makers. This role supports program management activities around risk adjustment data management and submissions to CMS. This role… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Risk Adjustment Business Operations Analyst assumes a pro-active approach in ensuring the accuracy and ... integrity of key risk adjustment performance metrics through coordination of analytical processes, investigation and interpretation of regulated markets risk … more
- UPMC (Pittsburgh, PA)
- UPMC Health Plan has an exciting opportunity for a Risk Adjustment Clinical Auditor/ Analyst position in the Medicare department. This is a full time position ... remote.. The Clinical Auditor/ Analyst is an integral part of the Risk Adjustment Department and is responsible for reviewing and auditing medical records for… more
- Humana (Louisville, KY)
- …hybrid based on business discretion. The MRA Finance team supports Humana's Medicare Risk Adjustment business area. The Finance team develops revenue and ... in Medicare regulations and payment models, monitors and reports on risk adjustment data submissions, and supports operations. This role will be responsible… more
- UCLA Health (Los Angeles, CA)
- Description As the Business Data Analyst for our Medicare Advantage Risk Adjustment team, you will be responsible for producing accurate and insightful ... Serve as a key departmental resource for application use related to risk adjustment coding guidelines and gap closure reporting. Salary Range: $78,500 -… more
- Highmark Health (Lansing, MI)
- …for efficiencies. May provide guidance to Associate level employees. **This role sits within our Risk Adjustment team - it is a remote based role - looking for ... some claims experience and looking to become familiar with risk adjustment .** **ESSENTIAL RESPONSIBILITIES** + Intake operational...3 - 5 years of experience in a Business Analyst or Business Process Analyst role or… more
- Molina Healthcare (Bowling Green, KY)
- …DESCRIPTION** **Job Summary** Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintain risk ... identify risks. Additional leadership opportunities are available to lead national risk adjustment studies. Prior experience in Medicaid risk adjustment… more
- Centene Corporation (Raleigh, NC)
- …perspective on workplace flexibility. **Position Purpose:** Executes Line 2 oversight of Risk Adjustment including monitoring, auditing, and Line 1 oversight. ... and effectively communicates findings to stakeholders, ensuring the highest quality of risk adjustment data. Develop algorithms and models to identify high… more