- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Manager plays a critical role in the development and execution of the corporate risk ... the end to end strategy by applying improvements and driving cost-effective risk adjustment actions across all organizational populations and products.… more
- Blue KC (Kansas City, MO)
- …**Employee discount program** **Job Description Summary:** Manages and executes the Blue KC Risk Adjustment (RA) programs for Commercial (ACA). Manages Risk ... coding, auditing and retrieval operations and if needed special projects within the risk adjustment programs. **Job Description** + Manage all risk … more
- Datavant (Richmond, VA)
- …life experiences to realize our bold vision for healthcare. **Role Overview** As a Product Manager , Risk Adjustment Coding Data Integration, you will own the ... data strategy and execution for Datavant's Retrospective Risk Adjustment Coding products, driving client data...data types + Data accuracy (upstream validation of data quality ) + Database uptime/availability + Optimized query response time… more
- LA Care Health Plan (Los Angeles, CA)
- Enterprise Risk Adjustment Analyst III Job Category: Accounting/Finance Department: Risk Adjustment Strategies & Initiatives Location: Los Angeles, CA, ... Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and...required to achieve that purpose. Job Summary The Enterprise Risk Adjustment Analyst III provides a key… more
- CVS Health (FL)
- …services within the existing program and vendors._ **Required Qualifications:** + _Expertise in Risk Adjustment payment models for MA, ACA and Medicaid._ + ... every day. **Position Summary** _The Purpose of the Sr. Manager , Business Consultation job is to drive prospective program..._Expertise in Risk Adjustment timelines and requirements_ + _Must… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …legally protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Quality & Risk Adjustment Provider Consultant Location: Hybrid | ... provider-facing or leadership-facing experience * Knowledge of Health Care Quality measures * Certified Risk Adjustment... Quality (CPHQ) or Certification in Health Care Quality and Manager (CHQM) * Registered Nurse… more
- ChenMed (Miami, FL)
- …departments to review medical records and other clinical documentation to identify appropriate risk adjustment codes and quality gap closure opportunities. A ... to collect and review documents to support the organization's quality and risk adjustment initiatives,...required. + Other duties as assigned and modified at manager 's discretion. KNOWLEDGE, SKILLS & ABILITIES: + Advanced understanding… more
- Molina Healthcare (Cedar Rapids, IA)
- …SKILLS & ABILITIES:** * 2+ years of program and/or project management experience in risk adjustment and/or quality * 2+ years of experience supporting ... **Job Description** **Job Summary** The Risk & Quality Performance Manager...Azure or SQL server * Healthcare experience and functional risk adjustment and/or quality knowledge… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …RSA initiatives, including Hierarchical Condition Categories (HCC) coding and other risk adjustment payment models. This role strategizes and collaborates ... Identifies opportunities for performance improvement related to system-wide HCC and other risk adjustment coding initiatives. Conducts medical record reviews and… more
- Bristol Myers Squibb (Devens, MA)
- … Risk Management will be responsible to enhance QRM capabilities for key Quality Risk Management (QRM) processes within the GxPs (GMP, GDP, GLP, Medical ... BMS network. Will provide together with the Associate Director Risk Management and Director Quality Risk...in their roles. Applicants can request a reasonable workplace accommodation/ adjustment prior to accepting a job offer. If you… more
- New York State Civil Service (Albany, NY)
- NY HELP No Agency Financial Services, Department of Title Senior Manager , Data Architecture (Financial Services Specialist 4 ( Risk ), SG-27) Occupational Category ... Auditing, Business, Business Administration, Economics, Econometrics, Finance, Mathematics, Market Analysis, Quality Assurance, or Risk Management and five (5)… more
- Amazon (Nashville, TN)
- …Amazon shipping is seeking a strategic and results driven leader to join as a Sr. Claims Risk Manager to lead the Claims charter for our org. We are looking for ... and be an effective communicator. As a Sr. Claims Risk Manager , you will own the WW...program charter by driving strategic initiatives for growth and quality improvement. * Build and manage relationships with key… more
- Amazon (Arlington, VA)
- …business teams to successfully capture and document control activities. Operating a quality rhythm of the business for managing compliance expectations. Using high ... - 4+ years of compliance program management, legal, governance, audit, risk /loss prevention, or equivalent experience - Bachelor's degree or equivalent -… more
- Amazon (Seattle, WA)
- …would you build to maximize customer satisfaction? Amazon is seeking a Program Manager who is passionate about Operations, has strong bias for action, and has ... experience leading multi-organizational projects. We are seeking a Program Manager who can drive organizational changes through global communication strategy,… more
- PNC (Pittsburgh, PA)
- …our Model Risk Management team at PNC. The position reports to the Senior Validation Manager for Market Risk and Counterparty Risk Models and is part of ... a Quantitative Analytics and Modeling Consultant Senior Validator within PNC's Model Risk Management organization, you can be based in Pittsburgh, PA. This position… more
- New York State Civil Service (Albany, NY)
- …and Counterparty Managero Market, Liquidity and Asset Liability Management Risk Manager * Project Management Institute: Portfolio Management ... Auditing, Business, Business Administration, Economics, Econometrics, Finance, Mathematics, Market Analysis, Quality Assurance, or Risk Management and three (3)… more
- LifePoint Health (Las Cruces, NM)
- …compensation and episode of care payment Familiar with patient and practice risk adjustment mechanics and premium-based payment methodologies. * Familiar with ... *Job Title:* Quality Practice Manager (QPM) *Job Type:*Full-time...patient and practice risk adjustment mechanics, APR; HCC/RAF Familiar with… more
- Amazon (Seattle, WA)
- …improve or to build and innovate a new capability. You are a strong product manager with deep experience in the new product development process, and are a seasoned ... risks - Advance outcomes-based metrics to measure and quantify risk maturity - Build and maintain dashboards for customer...while also helping to raise the bar on high quality standards and operational excellence. Basic Qualifications - Bachelors… more
- Bristol Myers Squibb (Devens, MA)
- …no better place than here at BMS with our Cell Therapy team. The **Senior Manager Quality Systems, Site Data Integrity Lead** is responsible for ownership and ... knowledge of cGMPs and domestic regulatory requirements pertaining to Quality Systems and Quality Risk ...in their roles. Applicants can request a reasonable workplace accommodation/ adjustment prior to accepting a job offer. If you… more
- UMB Bank (Kansas City, MO)
- …and/or errors to identify cause and corrective action + Assist manager with daily workflow assignment, monitoring productivity, training, maintaining quality ... assurance and disaster recovery testing, or other projects as assigned by manager + Understand and remain current on related industry activity, changes, regulations,… more