- Molina Healthcare (Provo, UT)
- **Job Description** **Job Summary** The Senior Analyst will serve a key role on the RADV ( Risk Adjustment Data Validation) team, contributing to the ... required for audit response. + Collaborate with internal stakeholders-including IT, Risk Adjustment operations, clinical teams, and retrieval vendors-to ensure… more
- Molina Healthcare (Provo, UT)
- …role will be responsible for work around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling ... of complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data to evaluate healthcare intervention program performance.… more
- Molina Healthcare (Orem, UT)
- …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
- Molina Healthcare (Provo, UT)
- **JOB DESCRIPTION** **Job Summary** Responsible for Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and reporting. ... analyze impact. **KNOWLEDGE/SKILLS/ABILITIES** + Collaborate with Actuarial staff to calculate risk adjustment payment estimates. Document assumptions. + Analyze… more
- Molina Healthcare (UT)
- …Azure, AWS, or Hadoop + 3-5 years of experience in Analysis related to HEDIS and/or Risk Adjustment + 3-5 years of experience in working with complex data to ... **Job Description** **Job Summary** The Sr Analyst , Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops… more
- Molina Healthcare (Provo, UT)
- **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing ... of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's),… more
- Molina Healthcare (UT)
- …directly with **clinicians, nurses, or case management teams** + Familiarity with risk adjustment , value-based care models, or healthcare performance metrics + ... **JOB DESCRIPTION** **Job Summary** JOB SUMMARY: The Sr. Analyst , Healthcare plays a critical role in supporting clinical and operational initiatives by translating… more
- CenterWell (Salt Lake City, UT)
- …care programs, specialty provider network development, and financial performance. The Senior Analyst will work closely with market leadership, executive ... specific to cardiology, nephrology, orthopedics, and oncology + Familiarity with risk adjustment methodologies and population health analytics. + Experience… more
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