- UnitedHealth Group (Secaucus, NJ)
- …, Population Health, this key physician will provide expertise in population health, risk adjustment and quality. They will work collaboratively across a team ... (formerly Optum Tri-State NY) is seeking a Associate Medical Director , Network Partnerships to join our team in for...in teaching clinicians and clinical operations teams about Medicare Risk Adjustment , CMS STARs/HEDIS, and overall population… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …your true colors to blue. Under the direction of the Senior Director of Medicare Risk Adjustment and Analytics , the Associate Director of Risk ... for the Medicare and Merged Market segments. The Associate Director of Risk Adjustment Data and Analytics will oversee the reporting, analytics and… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …Adjustment Strategy Program Manager will report to the Senior Director of Medicare Risk Adjustment and Analytics . This role will manage the process of ... developing and maintaining the risk adjustment strategic plan. This position will track and monitor the key performance indicators of multi-year strategies and… more
- Datavant (Little Rock, AR)
- …to realize our bold vision for healthcare. **What we're looking for:** The incoming Risk Adjustment Analytics Manager will be stepping into a role ... manager will collaborate with other managers and the department director to set strategy and mobilize the team to...working with Medicare, ACA, and/or Medicaid risk adjustment models + 5+ years of data analytics… more
- CareFirst (Baltimore, MD)
- … across the organization within Medicare Advantage, Medicaid & ACA markets. The Risk Adjustment Director is responsible for strategic direction, leadership, ... **Resp & Qualifications** **PURPOSE:** The Director , Risk Adjustment oversees...as well as govern, support, and mentor associates within Risk Adjustment analytics , prospective &… more
- Corewell Health (Grand Rapids, MI)
- Job Summary The Director Risk Adjustment Prospective Operations & Risk Mitigation is the thought leader role responsible for ensuring the complete and ... role is a key strategic leader who initiates, develops and executes/implements the multi-product risk adjustment strategy set by the executive leaders of Risk… more
- Blue KC (Kansas City, MO)
- …with adoption financial assistance** **Employee discount program** **Job Description Summary:** The Director , Government Programs Risk Adjustment & Audit ... for internal coding operations and provider partners based on analytics and guidance for Risk Adjustment initiatives. + Develop and deliver educational… more
- Commonwealth Care Alliance (Boston, MA)
- … Director of Encounter Data Management within the Revenue Cycle Department, the Risk Adjustment Data Developer is responsible for the design, development, and ... of data systems and tools that support Commonwealth Care Alliance's (CCA) risk adjustment and Hierarchical Condition Category (HCC) revenue programs. This… more
- Wells Fargo (Charlotte, NC)
- **Model Risk Management (MRM)** is responsible for the enterprise-wide oversight and risk management of models across all phases of the model lifecycle. This ... identification, development, validation, implementation, usage, performance monitoring, documentation, and risk reporting of models. The team plays a critical role… more
- Bristol Myers Squibb (Princeton, NJ)
- …lives. Read more: careers.bms.com/working-with-us . **Summary:** We are currently seeking a Director , Health Systems Analytics (HSA) to join the US Pricing, ... the backdrop of a dynamic and changing pricing environment. These financial analytics of key pricing and access-related policy issues meaningfully impact our… more
- CVS Health (Boston, MA)
- …regulatory compliance. + Serve as a subject matter expert on CMS regulations, risk adjustment , and revenue optimization. + Collaborate with internal stakeholders ... CMS Part C/D operations. + 5+ years' experience working with CMS regulations, risk adjustment methodologies, and revenue management. + 5+ years' experience… more
- Bristol Myers Squibb (New Brunswick, NJ)
- …their personal lives. Read more: careers.bms.com/working-with-us . **Position Summary** The Director , Quality Risk Management will drive consistent Global ... leaders across the BMS network. This position will report into the Senior Director , Risk Management. **Key Responsibilities:** + Provide strategic and tactical… more
- Point32Health (VT)
- …care claims data, coding schemes (ICD-9/ICD-10, CPT/HCPCS, DRGs), and health status risk adjustment . In-depth health care reimbursement and managed care business ... (https://www.point32health.org/) . **Job Summary** Working under the direction of the Director or Senior Manager, the Senior Network Performance Analyst will be… more
- Mount Sinai Health System (New York, NY)
- …adjustment with a group of practices and (2) close partnership with the CDQI Director to drive accurate risk adjustment throughout the system. This ... hardwiring processes to drive excellence in efficiency of care, quality and accurate risk adjustment for all populations served, especially our patients covered… more
- CenterWell (Baton Rouge, LA)
- …+ Partner with MRA Strategy and Analytics teams to establish risk adjustment analytics to identify coding improvement opportunities, provider ... entities within the Primary Care Organization. **Strategy:** + In partnership with AVP, Risk Adjustment and AVP, MRA Strategy, responsible for driving ongoing… more
- RELX INC (Alpharetta, GA)
- …technology and analytics to assist them in evaluating and predicting risk and enhancing operational efficiency. Our insurance risk solutions help drive ... can learn more about LexisNexis Risk at the link below. https:// risk .lexisnexis.com/insurance About the Role The Senior Director , Market Intelligence will… more
- Hensel Phelps (Greeley, CO)
- …planning and extends throughout the life of the property. Position Description: The Director of Finance (Finance Director ) oversees all financial aspects of ... company as well as possible risks and investments. The Director of Finance is a reliable leader with broad...company's finance IT system. + Provides strategic direction regarding risk management and compliance. + Set targets for and… more
- RELX INC (Washington, DC)
- About the Business: LexisNexis Risk Solutions is the essential partner in the assessment of risk . Within our Government vertical, our solutions assist government ... informed decisions to enhance investigations. You can learn more about LexisNexis Risk at the link below. https:// risk .lexisnexis.com/government About the Team:… more
- RELX INC (Boca Raton, FL)
- Director of Market Planning: Digital Identity (IDV, Document Authentication, and Biometric) Are you a subject matter expert in Digital Identity Solutions? Are you a ... enjoy tracking and shaping policy? About the Business LexisNexis Risk Solutions is the essential partner in the assessment...our Team This role reports directly to the Sr. Director of Transformational Markets. About the Role This position… more
- RELX INC (Houston, TX)
- …link at: https://www.icis.com/explore . About the Role ICIS is seeking an exceptional Director of Product Management to lead its Insight & Hindsight portfolios - the ... influence business outcomes through innovative product development and go-to-market execution. As Director , you will own the commercial roadmap for both the Insight… more
