Medicare Risk Adjustment jobs in Costa Mesa, CA

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Business Analyst III CHAPS
HealthCare Partners - 216 reviews - El Segundo, CA 90245
Maintain and support policies, processes and systems related to Medicare risk. 1 or more years CMS-Risk Adjustment experience....
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Project Manager
HealthCare Partners - 216 reviews - El Segundo, CA 90245
Support the planning and coordination of initiatives and operational programs related to Medicare Risk Adjustment....
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Associate Director, Actuarial Services - Minnetonka, MN or S...
Developing models to forecast revenue and demonstrating the value of Medicare Advantage (MA) Risk Adjustment services....
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Business Consultant - Risk Adjustment

Humana - 2,252 reviews - Irvine, CA
Prior experience in Risk Adjustment and HEDIS/STARs. The Business Consultant position is in the Medicare Risk Adjustment Encounter Submissions team under the...

Dir, Risk Adjustment

Molina Healthcare - 327 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...

Data Analyst - Risk Adjustment

Humana - 2,252 reviews - Irvine, CA
This role requires intimate knowledge of both Medicare and Clinical systems and data tables. The Analyst will be responsible for developing the reporting and...

AVP, Quality Improvement - Risk Adjustment

Molina Healthcare - 327 reviews - Long Beach, CA
4 years Medicaid/ Medicare experience. The Associate Vice President is a key Quality Improvement (QI) leader within the organization enterprise-wide....

Systems Data Consultant

Humana - 2,252 reviews - Irvine, CA
The Business Consultant position is in the Medicare Risk Adjustment Encounter Submissions team under the direction of the Program Manager....

Medical Case Manager

CalOptima - 17 reviews - Orange, CA
Interpret and apply established clinical criteria, Title 22, Medicare and Medi-Cal guidelines. Current and extensive knowledge of the NCQA, Title 22, Medi-Cal,...

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 ....

Performance, Compliance and Audit Training Manager

Prospect Medical Systems - Orange, CA 92868
Direct experience/knowledge of HCC methodology OR equitable Risk Adjustment methodology. Develop and implement a comprehensive compliance plan to ensure coding...
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Health Care Analyst II

SCAN Health Plan - 47 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...

Revenue Reconciliation Consultant (SME)

Dynamic Healthcare Systems - 3 reviews - Irvine, CA 92612
A minimum of seven (7) years relevant work experience with a minimum of five (5) years of experience involving records and information management, preferably in...
Health & Welfare Director
Medicare / commercial risk adjustment. Healthcare Analytics and its impact on risk adjustment and risk Management;...
Sponsored by PwC
Health Care Economics Consultant - Santa Ana, CA
Risk adjustment experience. Experience with Medicare and/or Star Rating. The Informatics team is responsible for using health information technology in the...
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