Medicare Risk Adjustment $100,000 jobs in Costa Mesa, CA

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Health & Welfare Director
Medicare / commercial risk adjustment. Healthcare Analytics and its impact on risk adjustment and risk Management;...
Physician - Medical Director
Humana, Inc - 2,554 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...

AVP, Medicare General Manager (CA)

Molina Healthcare - 403 reviews - Long Beach, CA
Experience with Medicare managed care plans, specifically with bid mechanics, risk adjustment, quality/Stars, Operations, Compliance....

Director Risk Adjustment - Data Analytics

Molina Healthcare - 403 reviews - Long Beach, CA
Risk adjustment project experience. The Director is responsible for setting appropriate risk scores for Molina Medicare members and Molina Medicaid members...

Medical Director, Behavioral Health

Molina Healthcare - 403 reviews - Long Beach, CA
Experience with NCQA, HEDIS, Medicaid, Medicare and Pharmacy benefit management, Group/IPA practice, capitation, HMO regulations, managed healthcare systems,...

Qual Risk Pt Sft Reg Cons

Kaiser Permanente - 4,513 reviews - Irvine, CA
NCQA, DMHC, Title 22, Medicare and Medi-Cal, Joint Commission etc.). THIS POSITION IS RESTRICTED TO EXCLUSIVE USE WITHIN THE QUALITY, RISK, PATIENT SAFETY AND...

Director of Medical Informatics

Molina Healthcare - 403 reviews - Long Beach, CA
Automates Predictive Modeling capabilities to assist the state health plans in providing accurate risk assessments and risk adjustments to government decision...

Long Beach AVP of Risk Adjustment - Managed Care

CareNational Healthcare Services (CNHS) - Long Beach, CA
$120,000 - $180,000 a year
Experience leading risk adjustment activities in a large, multi-state Medicare HMO. Knowledge of regulations related to Medicare Advantage, MMP, and Marketplace...
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Research Pharmacist

SCAN Health Plan - 49 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...

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