Medicare Risk Adjustment jobs in Costa Mesa, CA

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Healthcare Project Manager
Care1st Health Plan - 27 reviews - Monterey Park, CA
Risk Adjustment, HCC (Hierarchical Condition Category), process improvement. 3 or more years in Managed Care, Medicare STARS and clinical experience (or related...
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Health & Welfare Director
Medicare / commercial risk adjustment. Healthcare Analytics and its impact on risk adjustment and risk Management;...
Finance Manager
City of Hope - 129 reviews - Duarte, CA 91010
Other responsibilities include managing external consultants of all government reporting for Medicare, Medi-Cal and OSHPD, while maintaining compliance with all...

Manager Business Analysis -Risk Adjustment

UnitedHealth Group - 5,392 reviews - Santa Ana, CA 92725
Medicare Risk Adjustment experience. Risk Management or Audit certification. This role is within the Financial Analytics function of the Risk and Quality...

Healthcare Analyst

PrescribeWellness - Irvine, CA
Medicare Advantage risk adjustment and financial reconciliation; Our mission is to inspire collaboration among trusted pharmacists, healthcare institutions, and...
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Clinical Quality Consultant

UnitedHealth Group - 5,392 reviews - Cypress, CA 90630  +1 location
Strong financial analytical background within Medicare Advantage plans (Risk Adjustment / STARS Calculation models)....

EDI Data Analyst

Dynamic Healthcare Systems - 3 reviews - Irvine, CA 92612
Three or more years of experience in Medicare risk adjustment and ANSI X12, working with Palmetto, CSSC, and CMS....

Manager of Network Programs

UnitedHealth Group - 5,392 reviews - Santa Ana, CA 92725  +2 locations
Utilizing data analysis, identify and target medical groups, providers and staff who will benefit from our Medicare Risk Adjustment training and documentation...

Mgr, Risk Adjustment

Molina Healthcare - 425 reviews - Long Beach, CA
Risk Adjustment Data Validation component. Sets policies related to risk adjustment. Manages staff in the risk adjustment division....

Medical Coding Quality Consultant

UnitedHealth Group - 5,392 reviews - Huntington Beach, CA 92615  +3 locations
Knowledge of Risk Adjustment HCCs. Targeting local providers who would benefit from our Medical Risk Adjustment training....

Health Care Analyst III

SCAN Health Plan - 51 reviews - Long Beach, CA 90806
Experience with CMS-HCC based Risk Model, Payment Cycle and Risk Score Calculation required. Works under minimal supervision to support all aspects of Medicare...

Qual Risk Pt Sft Reg Cons

Kaiser Permanente - 4,800 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...

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 ....
Quality Management LVN with Hedis knowledge
Care1st Health Plan - 27 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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Manager of Network Programs - Telecommute within Southern CA
Utilizing data analysis, identify and target medical groups, providers and staff who will benefit from our Medicare Risk Adjustment training and documentation...

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