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Risk Adjustment Remote Jobs

44 fresh jobs found

Lead, Client Operations
Remote

Operational program management Commercial membership Cms medicare stars program Client operations Health Plan Operations Risk Adjustment Invoicing Conflict Management Claims management +10

Senior Mid Full Time

USD 54K+

Patient Care Advocate
Remote-AR, United States

Centene Corporation

Member advocacy Provider experience Quality Initiatives Health administration HEDIS NCQA CPT coding Health coaching Risk Adjustment +34

USD 52K+

Operations Administrator RQC
Remote, United States

Clinical Chart Review Risk Adjustment Coding Risk Adjustment Healthcare systems Medical terminology SharePoint Confidentiality Microsoft Office Suite Coding +19

Entry Mid Full Time

USD 40K+

Data Analyst I Reporting and Analytics
Remote, United States

Healthcare data manipulation CMS guidelines Spreadsheet Applications Database Applications Exchange Risk Adjustment Data manipulation Predictive Modeling CMS +25

Entry Mid Full Time

USD 63K+

VBC Healthcare Data Analyst
United States - Remote

Database Tools Azure Synapse Risk Adjustment PySpark Microsoft Access Value-based care Relational databases BI Multitasking +15

USD 80K+

Data Scientist II: Risk Adjustment Analytics
Remote

Analytics methods Models Technology Platform Risk Adjustment Statistical modeling Advanced Analytics Data Pipelines Outreach Modeling +24

USD 131K+

Actuarial Analyst II (Medicare)
Ohio WFH, United States

Medicare risk adjustment Decision support Pricing models Risk Adjustment Data manipulation Actuarial science Microsoft Suite Relational databases SAS +26

USD 70K+

Associate Actuary - Risk Adjustment
Remote-MO, United States

Centene Corporation

Probability VBA Risk Adjustment Actuarial SAS Mathematics Statistics Health Insurance Coding +15

USD 86K+

Associate Actuary
Remote US, United States

Actuarial methods VB Medicare data MS Power BI Business writing Medicare Advantage Analyzing Risk Adjustment Statistical methods +63

USD 106K+

Individual & Family Plans (IFP) Quality Review & Audit Senior Supervisor - Remote - Cigna Healthcare
Tennessee Work at Home, United States

The Cigna Group

Quality audit HCC coding Quality review ICD Risk Adjustment ICD-10-CM Coding Guidelines Medical Coding EHR +25

Senior Full Time

USD 68K+

Data Analyst II Medical Economics
Remote-FL, United States

Centene Corporation

Claims pricing Clinical outcomes Claims payment Data verification Contract Analysis Healthcare Analytics Risk Adjustment Actuarial Actuarial science +44

USD 55K+

Data Analyst III Healthcare Analytics
Remote-FL, United States

Centene Corporation

Clinical outcomes Claims payment Data verification Microsoft Power BI Healthcare Analytics Risk Adjustment Actuarial Actuarial science Healthcare administration +46

Senior Mid Full Time

USD 68K+

Senior Analyst, Network Analytics
Remote

Medical economics Payment Integrity Quality of care Models Healthcare Analytics Technology Platform Contract negotiations Network Operations Risk Adjustment +32

Senior Mid Full Time

USD 72K+

Quality Practice Advisor
Remote-IL, United States

Centene Corporation

Clinical Relationship Management Cphq Documentation standards Risk Adjustment Coding Medical record documentation NCQA Provider education Health Plan HEDIS +23

USD 52K+

Senior Product Designer
United States-%LABEL POSITION TYPE REMOTE WITHIN ONE%

Abstraction Submissions Data Retrieval Motion Graphics Design principles Risk Adjustment User-centered design Healthcare Data Wireframing +27

Senior Full Time

USD 120K+

Actuarial Analyst
Remote US, United States

Tables Healthcare quality Risk Adjustment Actuarial Actuarial science Predictive Modeling Consumer Experiences Risk Collaborative +36

Entry Mid Full Time

USD 80K+

Vice President of Provider Sales
United States - Remote

Quality of care Network development Risk Adjustment Value-based care Strategic Relationships Enterprise solutions Consultative sales C CRM +6

Exec Senior Full Time

USD 150K+

Patient Care Advocate
Remote-ME, United States

Centene Corporation

Member advocacy Quality Initiatives Provider experience NCQA Health administration Telephonic Communication HEDIS Risk Adjustment Telephonic Outreach +35

USD 52K+

Data Analyst
Remote - USA

Clover Health Remote-first

Risk Adjustment Healthcare Data Dashboard Creation BI Tools Value-based care Claims Dashboards Care management Data Modeling +17

USD 126K+

Sr. Contracts Manager
United States-%LABEL POSITION TYPE REMOTE WITHIN ONE%

Contract Law Healthcare Regulations Contract administration Risk Adjustment NLP Natural Language Processing Quality improvement Contract management Quality +16

Senior Full Time

USD 110K+

HCC Physician Coding Auditor
Work at Home - Ohio - Other, United States

Ensemble Health Partners

Education Development Physician coding Coding and Billing Technical resource Provider education Risk Adjustment Color Guidance Revenue Cycle Management +17

USD 51K+

Program Manager Operations
Remote, United States

HEDIS Risk Adjustment Exchange Interpersonal Communication Client Management Accountability Microsoft Outlook Microsoft PowerPoint Execution +21

USD 68K+

Risk Adjustment Auditor II
Portland, OR, United States

Cambia Health Solutions

Chart reviews Health systems operations Coding conventions Provider coding Clinical coding ICD-10 Coding DO Reimbursement methodologies Provider education +17

USD 62K+

Registered Nurse RN Population Health Remote
Remote Greeley CO, United States

Community nursing Chart reviews Critical care Medicare Advantage Cerner HEDIS Risk Adjustment Utilization Review Primary Care +11

USD 112K+

Risk Adjustment Specialist II - (non-clinical)
Remote-AZ, United States

Centene Corporation

ICD10 coding Claims knowledge Risk Adjustment Coding Medical record documentation Health Plan Provider education Health administration Risk Adjustment Methodologies +25

USD 95K+

Data Analyst III Medical Economics
Remote-MO, United States

Centene Corporation

Claims payment Clinical outcomes Data verification Microsoft Power BI Healthcare Analytics Risk Adjustment Actuarial Healthcare administration Actuarial science +46

Senior Mid Full Time

USD 68K+

Clinical Coding Manager
United States-%LABEL POSITION TYPE REMOTE WITHIN ONE%

Abstraction Interdisciplinary communication Submissions Clinical coding Data Retrieval Medical Record Review Risk Adjustment Cultural Sensitivity Healthcare Data +23

Senior Mid Full Time

USD 80K+

Asst. Director Risk Adjustment Analytics
Portland, OR, United States

Cambia Health Solutions

Lean process improvement Analytical Modeling Health care systems DO Risk Adjustment Provider Relations Requirements Gathering Mathematics Lean +11

Exec Senior Full Time

USD 124K+

Provider Educator - Risk Adjustment
Portland, OR, United States

Cambia Health Solutions

HCC coding Health Care Industry Knowledge Dental Terminology ICD-10 Coding Reimbursement methodologies Provider education Risk Adjustment Provider Relations Medical terminology +9

USD 78K+

Manager, Risk Adjustment & Performance
United States - Remote

Vendor implementations Clinical continuity of care Business Metrics Risk Adjustment ICD-10-CM Electronic Health Records Healthcare Data EHR Dashboards +7

Senior Mid Full Time

USD 120K+

Director, Risk Adjustment & Performance
United States - Remote

Vendor implementations Clinical continuity of care Risk Adjustment ICD-10-CM Electronic Health Records Healthcare Data EHR Data integrity Auditing +5

Exec Senior Full Time

USD 175K+

IFP Business Analytics Advisor – ACA HHS Risk Adjustment - Remote
Washington Work at Home, United States

The Cigna Group

Database manipulation Claims Data Healthcare Analytics Risk Adjustment Actuarial science Clinical Data Healthcare Data Business Analytics Health Services +26

USD 96K+

Quality Practice Advisor
Remote-IN, United States

Centene Corporation

Cphq Medical record documentation Risk Adjustment Coding Documentation standards NCQA Provider education ICD-9 Risk Adjustment HEDIS +19

USD 52K+

Director, Risk Adjustment
Remote-IL, United States

Centene Corporation

Provider outreach Quality Initiatives Healthcare operations Financial Forecasting Risk Adjustment Actuarial Cross-functional Team Leadership Medical management CMS +21

Exec Mid Full Time

USD 110K+

Strategy Advancement Advisor
Remote US, United States

STARS Provider engagement Medicare Advantage Analyzing Interoperability Risk Adjustment Strategic decision-making Report Preparation Strategy Development +47

Senior Mid Full Time

USD 115K+

Senior Sales Engineer
Remote- United States

Risk Score Accuracy Quality Measurement Technical Consultation Availability Data-driven solutions Risk Adjustment Business solutions HEDIS Proposal Preparation +25

Senior Full Time

USD 90K+

Risk Adjustment Medical Coder (Remote)
Boone, NC, US

High Country Community Health

ECW Billing System Coding Audits Documentation Guidelines HCC coding Risk Adjustment Provider education ICD-10-CM Medical Coding HCPCS +2

USD 55K+

Lead Integration Engineer
United States-%LABEL POSITION TYPE REMOTE WITHIN ONE%

System Integration Design Code Libraries Open-source Forums Mirthconnect Actian Software Specifications Dell Boomi Submissions Epic ehr +28

Senior Full Time

USD 100K+

Integration Engineer
United States-%LABEL POSITION TYPE REMOTE WITHIN ONE%

System Integration Design Software Specifications Jboss Fuse Code Libraries Open-source Forums Dell Boomi Submissions IBM WebSphere Epic ehr +30

USD 100K+

Financial Analytics Professional
Remote US, United States

Interpreting Data Financial analytics Microsoft Power BI Analyzing Risk Adjustment Valuation Actuarial Risk SAS +37

Senior Mid Full Time

USD 66K+

Vice President of Provider Engagement
United States - Remote

Provider engagement strategy Consultative conversations Network development Provider engagement Risk Adjustment Value-based care KPI Tracking Clinical operations Performance Optimization +18

Exec Senior Full Time

USD 180K+

Population Health Director
United States - Remote

Clinical decision support Quality of care Provider engagement Risk Adjustment Population health Value-based care Roadmap Development Clinical operations Resource Management +19

Exec Senior Full Time

USD 110K+

Principal Product Manager, Data & Analytics
United States - Remote

Healthcare Analytics Risk Adjustment KPI Monitoring Clinical operations Stakeholder Collaboration BI Conflict Resolution Cloud platforms Financial modeling +22

Senior Full Time

USD 150K+

Principal Product Manager, Platform Solutions
United States - Remote

Customer Feedback Utilization Lean Canvas Business Process Design Risk Adjustment Technical Specifications Cross-functional Team Leadership KPI Monitoring Roadmap Development User Acceptance Testing +21

Senior Full Time

USD 150K+

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