Medicare Risk Adjustment $60,000 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;...
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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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...

Mgr, Risk Adjustment

Molina Healthcare - 400 reviews - Long Beach, CA
Risk Adjustment Data Validation component. Sets policies related to risk adjustment. Manages staff in the risk adjustment division....

Business Analyst

Dynamic Healthcare Systems - 3 reviews - Irvine, CA 92612
Medicare Advantage risk adjustment and financial reconciliation; Dynamic Healthcare Systems, of Irvine, CA is seeking a Business Analyst ....

Health Care Analyst II

SCAN Health Plan - 49 reviews - Long Beach, CA 90806
Experience with CMS-HCC based Risk Model, Payment Cycle and Risk Score Calculation. Works under general supervision to support multiple aspects of Medicare Risk...

AVP, Medicare General Manager (CA)

Molina Healthcare - 400 reviews - Long Beach, CA
Experience with Medicare managed care plans, specifically with bid mechanics, risk adjustment, quality/Stars, Operations, Compliance....

DATA ANALYST - HEALTHCARE REQUIRED - Medicare Advantage, Ris...

agilon health - Long Beach, CA
Data Analysis including Medicare Advantage, Risk Adjustment, Medicaid, Insurance Exchange, and Commercial lines of business:....
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Medicare Revenue Reconciliation Consultant (SME)

Dynamic Healthcare Systems - 3 reviews - Irvine, CA 92612
As it relates to Medicare Revenue Reconciliation. Dynamic Healthcare Systems is hiring for the newly created position of Medicare Revenue Reconciliation...

Director Risk Adjustment - Data Analytics

Molina Healthcare - 400 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...

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...

Medical Director, Behavioral Health

Molina Healthcare - 400 reviews - Long Beach, CA
Experience with NCQA, HEDIS, Medicaid, Medicare and Pharmacy benefit management, Group/IPA practice, capitation, HMO regulations, managed healthcare systems,...
Manager Business Analysis - Santa Ana, CA
Optum Operations - Santa Ana, CA 92701
Medicare Risk Adjustment experience. Risk Management or Audit certification. Challenge yourself, your peers and our industry by shaping what health care looks...
QI HEDIS 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...
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