Medicare Risk Adjustment $40,000 jobs in Costa Mesa, CA

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Risk Adjustment Analyst
DW Simpson Global Actuarial Recruitment - California
Our Western client seeks a professional with 5-7 years of experience in healthcare analytics along with solid understanding of Medicare Risk Adjustment Payment...
Desired Experience: Microsoft SQL Server
RN Care Team Manager
$65,000 a year
You can also assist in improving member focused HEDIS measures, such as preventative wellness, which ensure our members keep healthy or Risk Adjustment which...
Desired Experience: Case Management, RN, Managed Care
Easily apply
Remote Senior Software Engineer (EMR)
Pulse8 Inc. - United States
Pulse8 has developed a suite of uniquely pragmatic solutions that are revolutionizing Risk Adjustment and Quality Management....
Desired Experience: JavaScript, Microsoft SQL Server, Service-Oriented Architecture, HTML5, .Net, MySQL, NoSQL
Easily apply

Risk Adjustment Data Analyst

Dynamic Healthcare Systems - 3 reviews - Irvine, CA 92612
Medicare Risk Adjustment Payment Methodology and Data Knowledge; The Risk Adjustment Data Analyst will support Dynamic's risk adjustment customers....
Desired Experience: Data Mining, Microsoft SQL Server, Oracle, SAS, SQL

Manager, Risk Adjustment - Medicare

Molina Healthcare - 818 reviews - Long Beach, CA
Manager, Risk Adjustment - Medicare - (1801866). Proficiency with risk adjustment methodologies. Sets policies related to risk adjustment....
Desired Experience: Management Experience

Risk Adjustment Auditor Education

WellCare - 913 reviews - Cypress, CA 90630
Manager, Risk Adjustment Programs. Works on additional risk adjustment audit requests (i.e. Required 2 years of experience in coding with knowledge of Medicare...
Desired Experience: Microsoft Powerpoint, CPT-4, Microsoft Office, Excel, Microsoft Word, Medical Terminology, Medical Coding

Supervisor, Finance (Risk Adjustment)

CalOptima - 37 reviews - Orange, CA
Act as the subject matter expert for data flows and systems that support Medicare risk adjustment related activities....
Desired Experience: Microsoft SQL Server, Financial Modeling
Easily apply

Business Analyst - Risk and Clinical Documentation (Remote)

Landmark Health - 34 reviews - Huntington Beach, CA
Analyze Claims and Risk Adjustment data and build out Risk Models. In this key role, the Business Analyst, Risk & Clinical Documentation will be responsible for...
Desired Experience: Microsoft SQL Server, SharePoint, Managed Care

Entry Level Nurse Coder

Advanced Medical Management - 21 reviews - Long Beach, CA 90815
RISK ADJUSTMENT CODER. Knowledge of Medicare managed care. Audit provider documentation of CPT, ICD-9 and ICD-10 codes to ensure adherence with coding and CMS...
Desired Experience: EMR Systems, Microsoft Powerpoint, Reliable Transportation, Excel, LVN, Driver's License, Medical Coding Certification, Managed Care
Easily apply

Application System Analyst

Dynamic Healthcare Systems - 3 reviews - Irvine, CA 92612
Medicare Advantage risk adjustment, financial reconciliation, Part D including PDE audit, enrollment, premium billing....
Desired Experience: SDLC

Claims Examiner - General Liability/Employment Practices Lia...

Sedgwick Claims Management Services - 896 reviews - Long Beach, CA
Approves and makes timely claim payments and adjustments; Subrogation, Second Injury Fund excess recoveries and Social Security and Medicare offsets....
Desired Experience: Microsoft Office

Manager Clinical Documentation Strategy and Operations

Concerto HealthCare - 23 reviews - Aliso Viejo, CA
Expertise in Medicare Risk Adjustment analytics and reporting. The Manager, Clinical Documentation Strategy and Operations will lead the production and analysis...
Desired Experience: Time Management, Microsoft Powerpoint, Excel, Managed Care

Informatics Analyst II

SCAN Health Plan - 80 reviews - Long Beach, CA 90806
Knowledge of CMS Star Rating methodology, HEDIS, and HCC risk adjustment methodology preferred. Rated as one of the top Medicare Advantage plans in California,...
Desired Experience: Data Mining, R, SAS, SQL, Data Analysis