Medicare Risk Adjustment jobs in Costa Mesa, CA

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QI HEDIS Network Support Nurse
Care1st Health Plan - 26 reviews - Monterey Park, CA
Provide support to the Medicare HCC risk adjustment review process and medical record audit. Experience with Medicare HCC Risks and ICD-10 and CPT codes...
Easily apply
Sr. Healthcare Economics Analyst - Santa Ana, CA
Understanding of Medicare Advantage Risk Adjustment. Produce and review reports specific to risk adjustments for various markets....

Research Pharmacist

SCAN Health Plan - 48 reviews - Long Beach, CA 90806
Knowledge of CMS Star Rating methodology, HEDIS, and HCC risk adjustment methodology. Rated as one of the top Medicare Advantage plans in California, SCAN...

Director of the Clinical Documentation Improvement

Alta Hospitals System, LLC - 3 reviews - Norwalk, CA
The individual will develop strategies that will address risk adjustment and other quality measures that address hospital and physician performance....

Director of the Clinical Documentation Improvement

Alta Hospitals System Corporate/CBO - Norwalk, CA
The individual will develop strategies that will address risk adjustment and other quality measures that address hospital and physician performance....

Medical Director, Behavioral Health

Molina Healthcare - 397 reviews - Long Beach, CA
Experience with NCQA, HEDIS, Medicaid, Medicare and Pharmacy benefit management, Group/IPA practice, capitation, HMO regulations, managed healthcare systems,...
Implementation Engineer
Episource LLC. - 2 reviews - Gardena, CA 90248
Prior healthcare industry experience with Risk Adjustment or Health Plans. Episource, with over 1500 employees worldwide, is a leading provider of risk...
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Remote Care Coordinator / Case Management (Work from home)
Advantmed LLC - Santa Ana, CA
$15 - $20 an hour
Advantmed partners with managed care organizations to deliver the optimal combination of capabilities unique to each organization needed to achieve the...
Easily apply
Health & Welfare Director
Medicare / commercial risk adjustment. Healthcare Analytics and its impact on risk adjustment and risk Management;...
HEDIS Clinical Nurse Supervisor
Care1st Health Plan - 26 reviews - Monterey Park, CA
Experience with review, validation, and documentation of physician and physician’s office staff regarding HEDIS measures, Medicare HCC Risk adjustment and Risk...
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Health & Public Services - Utilization Management Manager
Accenture - 9,572 reviews - United States
And managing risk throughout the project lifecycle and making adjustments. Join Accenture and help transform leading organizations and....
HEDIS Quality Assurance Supervisor RN
Medix - 65 reviews - Monterey Park, CA 91756
 Experience with review, validation, and documentation of physician and physician's office staff regarding HEDIS measures, Medicare HCC Risk adjustment and...
Physician - Medical Director
Humana, Inc - 2,530 reviews - Los Angeles, CA
As Regional Risk Adjustment Medical Director you will use your clinical and risk adjustment expertise to influence, lead and educate providers on the importance...
Business Analyst with Healthcare Exp Only Local to Only Loca...
1 Point System - Ontario, CA 91764
This will result in recommendations for the installation of new systems or equipment, or to change existing systems and equipment Development of business...

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