Register
Recruit Create CV

Risk Adjustment BA Jobs

Qa - Risk Adjustment Rn
By The Judge Group At United States
Bachelor’s Degree or equivalent combination of education and experience
Continues education to maintain high level of proficiency in Risk Adjustment field.
Maintains RN and CRC certifications.
Executes other responsibilities per business needs.
Must have minimum of 3 years of clinical experience as a Registered Nurse (RN)
Must have Certified Risk Adjustment Coder (CRC)Certification
Coder 1-Risk Adjustment Jobs
By Loma Linda University Health At , , Ca

- Managed Care (Remote/Hybrid, Full-Time, Day Shift) -

Supervisor, Risk Adjustment & Quality
By Wellvana At , Remote
Experience in physician documentation/coding education. Experience in educating/training coders. ICD-10-CM Coding knowledge.
4+ years of experience in provider education
Knowledge of Medicare Advantage and other HCC entity program coding requirements.
Perform audits, coding, and provider education as per business needs
Experience working with ACO/ Health Plan
Minimum of 5 years’ experience in HCC-specific coding/auditing.
Records Ba Jobs
By TechFetch.com - On Demand Tech Workforce hiring platform At New York, NY, United States
Experience working with and managing backlog/sprints in tools like Azure DevOps or Jira required
Ability to work with and present to business stakeholders, scrum teams of developers, testers and project managers required
Need to be able to work remotely but available on Microsoft Teams during work hours within 15 minutes
Professional scrum master and other business analysis related certifications preferred.
Experience with Power Apps strongly preferred
Ability to identify and act on gaps and issues pro-actively
Project Manager Risk Adjustment- Remote U.s.
By CVS Health At , , Ct $60,300 - $130,000 a year

This position is responsible for provider/vendor/network outreach, production management, and reporting for the Risk Adjustment Retrospective Program for ACA, Medicare, MMP and DSNP lines of ...

Entry Level Ba Jobs
By Mobile Apps US LLC At New York City Metropolitan Area, United States
Knowledge of SQL fundamentals and experience with structured query language.
Familiarity with project management concepts and tools such as MS Project.
Strong analytical and problem-solving skills.
Excellent written and verbal communication skills.
Proficiency in requirements gathering and documentation techniques.
Bachelor's degree in Business Administration, Computer Science, or a related field.
Risk Adjustment Analyst Sr (Remote; Medicaid Encounters)
By Baylor Scott & White Health At , Remote $36.26 an hour
EDUCATION - Bachelor's or 4 years of work experience above the minimum qualification
Monitors and oversees the end-to-end claims encounter management workflow.
Immediate eligibility for health and welfare benefits
EXPERIENCE - 3 Years of Experience
EXPERIENCE- Medicaid Encounters experience preferred; certified coder preferred
Our competitive benefits package includes the following
Manager, Medical Risk Adjustment Analytics
By CareSource At , Remote $87,000 - $152,300 a year
Minimum of three (3) years of professional level experience performing a broad range of data analysis and management required
Managed care or healthcare experience is preferred
Ability to interact with executive levels of management as well as external stakeholders
Leads triage and overall prioritization of Finance Information Technology needs using both direct reports and dedicated IT staff.
Identify and develop strategies for the application of emerging technology to Finance related problems.
Manage key vendor relationships in support of the work being completed
Retail Business Analyst (Ba)
By Perfaware At Seattle, WA, United States
➤ Identify and address cross-project dependencies and impacts to Stores, Call centers, IT, Business owners, Management etc.
➤ Bachelors or MBA or equivalent with solid experience in Business Analysis, Requirements Gathering.
➤ Familiarity with MS-Project, JIRA & Confluence or similar tracking and management tools
➤ Experience in documenting business requirements, functional design, business scenarios, etc.
➤ Translate business requirements into technical requirements and create user stories
➤ 5+ years of experience working as a Business Analyst or Functional Consultant for Retail /SupplyChain/CPG customers
Risk Adjustment Coder- Remote
By ConnectiCare At , Farmington, Ct $55,000 - $65,000 a year
Relevant Work Experience, Knowledge, Skills, and Abilities
Maintain industry coding knowledge, required certifications.
Report all diagnosis code findings (supported, add, edit, delete) and submit to HCC Risk Adjustment Coding Manager.
Meet with Risk Adjustment Coding Manager to share results of specific coding activities.
Report any coding outlier trends to Risk Adjustment Coding Manager for corrective action to maintain coding
2 – 3+ years of related, professional work experience required
Bi / Ba Jobs
By Holistic Partners, Inc At United States
Experience in User Acceptance Testing (UAT) Management and Status Reporting – UAT Strategy/Planning, UAT Preparation, UAT Execution and UAT Closure
Experience of SAP BOBJ, SAP HANA, SAP ERP.
Experience of Cloud, Google Cloud, and Cloud based technologies.
Experience of supply chain SAP domain with Order to Cash/Procure to Pay.
Experience with SAP TCode and ability to understand the ABAP programs
Preparing Jira user stories with testing scripts based on functional requirements and analysis documents
Ba/Qa Jobs
By United Business Solutions, Inc. At United States
Data analysis, understanding of technology, and assisting with the translation of business requirements into system requirements are important to this role.
The ideal candidate has at least 3 years of business analyst, business systems analyst, and/or business architect experience.
You will be asked to define user stories and elicit high level and detailed requirements from business stakeholders.
Some professional exposure to healthcare is required with experience in the healthcare payer space preferred.
Work with business stakeholders and partners to help identify and understand their requirements within the scope of a project.
Ensure that requirements clarify the business value and are accessible and understandable to any team.
Client Services Account Manager (Risk Adjustment Must)
By Episource At United States
4 to 6 years of account management or client project management experience
Strong time management skills, highly organized, self-motivated, and able to work under strict timelines with minimal day-to-day supervision
Proactively identify and manage opportunities to expand the scope of Episource solutions used by client organizations
Work collaboratively with internal departments and external vendors to coordinate project delivery and provide clients with a superior client services experience
Manage a high volume of client communication and manage the timely resolution of all outstanding client issues
Previous health care experience highly preferred, particularly in the Risk Adjustment space
Manager, Risk Adjustment Jobs
By agilon health At Dayton Metropolitan Area, United States
Responsible for team assignments, workload, and performance management
Take personal responsibility for personal growth including acquiring new skills, knowledge, and information.
6+ years, of experience in managed care or the health care industry
Manages the coding program in the market regardless of whether coders are agilon badged or leased from provider groups
Bachelor’s degree: or equivalent work experience required.
Accountable for the hiring and onboarding of all new Risk Adjustment team members (reviewers, coders, coordinators, etc.)
Risk Adjustment Business Analyst Consultant - Remote
By UnitedHealth Group At , Minneapolis, 55421, Mn $85,000 - $167,300 a year
Proven superior customer/consultant relationship management and collaboration skills
Provides business analysis support to the project management function from initiation through delivery in alignment with client expectations and business needs
Demonstrated solid leadership skills with proven ability to foster and manage senior-level relationships in a highly matrixed environment
Proven ability to influence with and without direct management/authority
Proven ability to manage medium sized teams across remote locations
Receives a moderate level of guidance and direction and uses previous experience to identify solutions
College Coop: Risk Adjustment Data Quality Analyst (Huynh)
By Independence Blue Cross At , Philadelphia, 19103, Pa
Working experience of Microsoft applications (PowerPoint, Excel, and Visio)
Working experience with SQL required
Experience with Power BI required
Experience with Tableau or other data visualization software programs preferred
Excellent oral/written communication skills required
Medicare HCC Risk Mitigation efforts
Healthcare Ba Jobs
By innoSoul, Inc. At Raleigh, NC, United States

Job ID: NC-703865 Hybrid/Local Healthcare BA with BPR, MS Project, RFP, Jira, SharePoint, Octane, ALM, Cloud agile/waterfall, and government experience Location: Dix Campus, Raleigh NC (NCDHHS-PMO) ...

Coder - Risk Adjustment
By Prominence Health Plan At , Reno, 89502, Nv $22.84 - $34.27 an hour
Minimum one (1) year experience in CMS HCC risk adjustment coding preferred
Successful completion of coding certification program (CCS,CPC, CRC, or RHIT through AHIMA/AAPC)
Will need to be well grounded in sound medical coding practices. Knowledge of HEDIS data collection is required
Excellent written and oral communication skills
Experience with NCQA HEDIS programs and data collection preferred
High School Diploma, GED or equivalent required
Risk Adjustment Medical Record Coder (Multiple Remote Positions Available)
By BlueCross BlueShield of Tennessee At , Chattanooga, 37402, Tn
Perform or participate in special projects as directed by management.
Please note: This is a remote, full time position with benefits. All equipment will be provided.
Associates degree or equivalent work experience required. Equivalent experience is defined as 2 years of professional work experience
1 year - Progressive medical coding and health care experience required.
Professional coding certification from AHIMA or AAPC (CPC, CCS, RHIT, RHIA)
Proven analytical and problem solving skills and ability to perform non-routine analytical tasks
Qa / Ba Jobs
By IT America Inc At Jacksonville, FL, United States

10+ Years of Over all IT Experience

Jacksonville, Florida ( Day 1 On-Site )

Are you looking for an exciting opportunity to use your Risk Adjustment expertise to make a real difference? We are looking for a Risk Adjustment Business Analyst to join our team and help us develop and implement innovative solutions to improve our risk adjustment processes. You will have the chance to work with a dynamic team of professionals and make a lasting impact on our organization. If you are passionate about making a difference and have the skills and experience to make it happen, then this is the job for you!

Overview Risk Adjustment Business Analysts (BA) are responsible for analyzing and interpreting data related to risk adjustment programs and providing insights to support the development of risk adjustment strategies. They work closely with stakeholders to ensure that risk adjustment programs are effective and compliant with regulations. Detailed Job Description Risk Adjustment Business Analysts are responsible for analyzing and interpreting data related to risk adjustment programs. They use data to identify trends and patterns, and to develop insights that can be used to inform risk adjustment strategies. They work closely with stakeholders to ensure that risk adjustment programs are effective and compliant with regulations. They also provide guidance and support to stakeholders on risk adjustment related topics. Risk Adjustment BA Job Skills Required
• Strong analytical and problem-solving skills
• Excellent communication and interpersonal skills
• Knowledge of risk adjustment programs and regulations
• Ability to interpret and analyze data
• Proficiency in Microsoft Office Suite
• Knowledge of statistical software packages
• Ability to work independently and as part of a team
Risk Adjustment BA Job Qualifications
• Bachelor’s degree in a related field
• At least 5 years of experience in risk adjustment or related field
• Knowledge of risk adjustment programs and regulations
• Proficiency in Microsoft Office Suite
• Knowledge of statistical software packages
Risk Adjustment BA Job Knowledge
• Knowledge of risk adjustment programs and regulations
• Knowledge of data analysis and interpretation
• Knowledge of statistical software packages
• Knowledge of healthcare industry
Risk Adjustment BA Job Experience
• At least 5 years of experience in risk adjustment or related field
• Experience in data analysis and interpretation
• Experience in developing risk adjustment strategies
• Experience in working with stakeholders
Risk Adjustment BA Job Responsibilities
• Analyze and interpret data related to risk adjustment programs
• Develop insights to inform risk adjustment strategies
• Ensure compliance with regulations
• Provide guidance and support to stakeholders
• Monitor and evaluate risk adjustment programs
• Prepare reports and presentations on risk adjustment topics