• Risk Adjustment Audit…

    Molina Healthcare (Salt Lake City, UT)
    …and confirm required data elements. + Collaborate with internal teams-including IT, Risk Adjustment operations , and clinical teams-to ensure accurate ... Analyst will play a supporting role on the RADV ( Risk Adjustment Data Validation) team, assisting in...team, assisting in the execution of CMS and internal audit activities. This position contributes to the development of… more
    Molina Healthcare (08/08/25)
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  • Risk Adjustment Analyst, Health…

    University of Utah Health (Murray, UT)
    …information to Compliance and Audit partners for awareness of trends, processes, and risk adjustment issues. + Works closely with Compliance and Audit ... trust that are integral to our mission. EO/AA_ + Risk Adjustment Analyst position provides support for...University of Utah Hospitals and Clinics represents our clinical operations for the larger health system. **Responsibilities** + Performs… more
    University of Utah Health (08/13/25)
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  • Director, Prospective + Concurrent Risk…

    Datavant (Salt Lake City, UT)
    …vision 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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  • Auditor, Risk Adjustment (Remote)

    Molina Healthcare (Layton, UT)
    …chart retrieval, file transmissions, and adherence to applicable timelines * Support all risk adjustment audit related projects to ensure goals, objectives, ... the daily operations of all aspects of risk adjustment data validation related activities, including,...adjustment payment in all markets * Performs monthly audit on internal Molina Coding Specialists * Audits external… more
    Molina Healthcare (07/25/25)
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  • Director, Clinical Data Acquisition (HEDIS…

    Molina Healthcare (Layton, UT)
    …for HEDIS, or HEDIS-like projects, Risk Adjustment , Risk Adjustment Data Validation, and other state specific audit projects and deliverables. This ... * Experience developing performance measures that support business objectives. + HEDIS Operations experience. + Risk Adjustment and Data Validation… more
    Molina Healthcare (08/21/25)
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  • Client Coding Project Manager - Full Time - Remote

    Datavant (Salt Lake City, UT)
    …key role in ensuring coding compliance and accuracy + Monitor the performance of the Risk Adjustment Operations both internally and with coding vendors + ... The individual will provide superior quality by performing audits pertaining to risk adjustment coding efforts. The individual will be responsible for… more
    Datavant (07/26/25)
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  • Sr Compliance RCM & Coding Auditor

    Humana (Salt Lake City, UT)
    …analyze large data sets + Knowledge of healthcare compliance, mainly primary care and risk adjustment , pharmacy knowledge a plus + Certified Coder (CPC, CRC, ... Regulatory Compliance team that supports the PCO is responsibility to assess, investigate, audit and validate the mitigation of compliance risk across the… more
    Humana (08/23/25)
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