Talent.com
Risk Adjustment Analytics Manager

Risk Adjustment Analytics Manager

VirtualVocationsKissimmee, Florida, United States
job_description.job_card.variable_hours_ago
serp_jobs.job_preview.job_type
  • serp_jobs.job_card.full_time
job_description.job_card.job_description

A company is looking for a Sr Manager, Risk Adjustment Analytics.

Key Responsibilities

Lead financial and strategic aspects of CMS risk adjustment to provide actionable insights for executive decision-making

Create and maintain leadership reports on revenue financials and the impact of initiatives on Medical Loss Ratio (MLR)

Develop SQL queries against clinical operations and medical claims data to support analytics and stakeholder insights

Required Qualifications, Training, and Education

Bachelor's or Master's Degree preferred

Expert knowledge of CMS-HCC models V24 and V28

Understanding of claims data lifecycle and submission systems

Knowledge of regulations, compliance, and audits related to risk adjustment

serp_jobs.job_alerts.create_a_job

Manager Adjustment • Kissimmee, Florida, United States

Job_description.internal_linking.related_jobs
  • serp_jobs.job_card.promoted
Regulatory Manager

Regulatory Manager

VirtualVocationsKissimmee, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Regulatory Manager.Key Responsibilities Manage regulatory submissions, documentation, education, training, and compliance Coordinate research activities with clinical ...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
State Licensed Actuary

State Licensed Actuary

VirtualVocationsKissimmee, Florida, United States
serp_jobs.job_card.full_time
A company is looking for an Actuary to join their Risk team.Key Responsibilities Oversee the design and enhancement of pricing and underwriting models in partnership with Underwriting Leverage s...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Business Analyst, P&C Claims

Business Analyst, P&C Claims

VirtualVocationsKissimmee, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Business Analyst, P&C Claims (Remote).Key Responsibilities Participate in meetings to define system requirements and identify existing issues Adhere to project timelin...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
General Liability Risk Analyst

General Liability Risk Analyst

Loews HotelsOrlando, FL, US
serp_jobs.job_card.full_time
General Liability Risk Analyst.The General Liability (GL) Risk Analyst supports Loews Hotels & Co.Risk Management team by proactively investigating, analyzing, tracking, and mitigating guest and th...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
Governance, Risk & Compliance (GRC) Expert

Governance, Risk & Compliance (GRC) Expert

eTeamOrlando, FL, US
serp_jobs.job_card.full_time
Key Responsibilities : Governance & Policy Management.Develop, implement, and maintain corporate governance policies and procedures. Establish and monitor internal controls aligned with industry best...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Senior TMF Reviewer

Senior TMF Reviewer

VirtualVocationsKissimmee, Florida, United States
serp_jobs.job_card.full_time
Key Responsibilities : Manage and perform TMF review of electronic Trial Master Files (eTMF) and related artifacts for clinical studies Ensure the TMF is audit-ready by performing checks and trac...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
Risk Consultant

Risk Consultant

ChubbOrlando, FL, US
serp_jobs.job_card.full_time
Focus on the core content of the job post, removing all extra metadata, navigation mentions, and redundant headers.Keep the formatting beautiful and high signal to noise ratio.serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days
  • serp_jobs.job_card.promoted
Enterprise Denial Analyst

Enterprise Denial Analyst

VirtualVocationsKissimmee, Florida, United States
serp_jobs.job_card.full_time
A company is looking for an Enterprise Denial Analyst responsible for reviewing technical denial claims and optimizing financial outcomes in the revenue cycle. Key Responsibilities Review technica...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
Operational Risk Officer

Operational Risk Officer

Seacoast BankOrlando, FL, US
serp_jobs.job_card.full_time
Based within the Enterprise Risk Management (ERM) Group, the Operational Risk Officer leads the build-out and evolution of the Bank's Second Line Operational Risk function.This role requires deep b...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Delaware Compliance Officer

Delaware Compliance Officer

VirtualVocationsKissimmee, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Compliance Officer in Delaware.Key Responsibilities Oversee compliance functions for the Delaware health plan and ensure timely submission of CMS Medicare SNP requireme...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
TPA Analyst

TPA Analyst

VirtualVocationsKissimmee, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a TPA Analyst to assist in plan administration and support a team environment.Key Responsibilities Assist Associates and Consultants with Defined Contribution Balance For...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Risk Adjustment Program Advisor

Risk Adjustment Program Advisor

VirtualVocationsKissimmee, Florida, United States
serp_jobs.job_card.full_time
A company is looking for an Individual & Family Plans (IFP) Risk Adjustment Program Management Advisor.Key Responsibilities Manage multiple interrelated projects for the IFP Risk Adjustment team,...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
Risk Manager / Orlando, Florida (Onsite)- 6 months Contract

Risk Manager / Orlando, Florida (Onsite)- 6 months Contract

StaffingOrlando, FL, US
serp_jobs.job_card.temporary
As a Risk Manager you will lead a team on cybersecurity consulting engagements responsible for managing, controlling, and mitigating client's risk management strategies. You will be a part of, and l...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Transaction Monitoring Analyst

Transaction Monitoring Analyst

VirtualVocationsKissimmee, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Transaction Monitoring Analyst.Key Responsibilities Monitor and analyze transactions for compliance with regulations Investigate suspicious activities and prepare repo...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
Title Express Auditor

Title Express Auditor

VirtualVocationsKissimmee, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Title Express Auditor.Key Responsibilities Perform comprehensive audits of open and closed assignments from various TE teams Conduct full-lot reviews, including call a...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
Operational Risk Officer

Operational Risk Officer

Seacoast National BankOrlando, FL, United States
serp_jobs.job_card.full_time
Based within the Enterprise Risk Management (ERM) Group, the Operational Risk Officer leads the build-out and evolution of the Bank's Second Line Operational Risk function.This role requires deep b...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_30
  • serp_jobs.job_card.promoted
  • serp_jobs.job_card.new
Temporary Regulatory Compliance Consultant

Temporary Regulatory Compliance Consultant

VirtualVocationsKissimmee, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Temporary Regulatory Compliance Consultant in Risk Consulting (Financial Services).Key Responsibilities Manage and deliver regulatory compliance assessments for financi...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_hours
  • serp_jobs.job_card.promoted
South Carolina Compliance Officer

South Carolina Compliance Officer

VirtualVocationsKissimmee, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Compliance Officer in South Carolina.Key Responsibilities Oversee compliance functions for the South Carolina health plan and ensure timely submission of CMS Medicare S...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
  • serp_jobs.job_card.promoted
Senior Regulatory Compliance Analyst

Senior Regulatory Compliance Analyst

VirtualVocationsKissimmee, Florida, United States
serp_jobs.job_card.full_time
A company is looking for a Senior Regulatory Compliance Analyst to advance its Corporate Compliance Program.Key Responsibilities Lead internal audits, operational reviews, and risk assessments M...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_1_day
Risk Management Specialist (SOC 2 / CAPA)

Risk Management Specialist (SOC 2 / CAPA)

AssistRxMaitland, FL, US
serp_jobs.filters.remote
serp_jobs.job_card.full_time
serp_jobs.filters_job_card.quick_apply
We are in search for a Compliance Specialist.Compliance works to ensure controls and safeguards are in place to promote adherence to applicable federal and state laws, assess risks to the organizat...serp_jobs.internal_linking.show_moreserp_jobs.last_updated.last_updated_variable_days