- CVS Health (Jackson, MS)
- …to make health care more personal, convenient and affordable. As the Senior Manager, Risk Adjustment ( Medicare ) will be responsible for leading Risk ... Adjustment for the Georgia & the Gulf States Medicare Market, specifically in Mississippi. This role will have...This role will have responsibility in maintaining and improving risk adjustment accuracy by partnering closely with… more
- CVS Health (Atlanta, GA)
- …to make health care more personal, convenient and affordable. As the Senior Manager, Risk Adjustment ( Medicare ) will be responsible for leading Risk ... Adjustment for the Georgia & the Gulf States Medicare Market. This role will have specific responsibility for...have specific responsibility for Georgia in maintaining and improving risk adjustment accuracy by partnering closely with… more
- The Cigna Group (UT)
- …$5,000 in addition to base salary._** This role is responsible for supporting Cigna Medicare Advantage's Risk Adjustment program for assigned populations in ... matrix partners of Cigna Medicare 's programs specific to CMS Risk Adjustment and HCC Coding Processes. It will require expertise in ICD-10-CM/outpatient and… more
- Martin's Point Health Care (Portland, ME)
- …refinement, maintenance, monitoring and oversight of Medicare Risk Adjustment initiatives and operations. The Senior Director is also responsible for ... "Great Place to Work" since 2015. Position Summary The Senior Director of Risk Adjustment ...Martin's Point also administers two health plans: Generations Advantage ( Medicare Advantage plans available throughout Maine and New Hampshire),… more
- Martin's Point Health Care (Portland, ME)
- …Plan which is growing and making an impact! Apply today for immediate consideration! The Senior Risk Adjustment Analyst in our Health Plan analyzes data, ... the data warehouse as key sources of data. The Senior Analyst uses their extensive content knowledge and analytical...used in complex conceptual analyses for all departments within Risk Adjustment Operations + Develops systematic reporting… more
- Point32Health (Canton, MA)
- …this individual will be responsible for supporting critical data submission functions for the Risk Adjustment Department (RAD) including risk adjustment ... and timely resolution of production issues pertaining to CMS and risk adjustment data submission, including issue investigation, business requirements,… more
- Humana (Columbus, OH)
- …executive to join the Healthcare Quality Reporting and Improvement (HQRI) organization as Senior Vice President (SVP), Risk Adjustment Operations and ... and audit processes) and HEDIS + Coding Operations for Medicare and Commercial Risk Adjustment ...and executive presence that will ensure effective interaction with senior and executive level audiences, both internally and externally.… more
- The Cigna Group (Baltimore, MD)
- …$5,000 in addition to base salary._** This role is responsible for supporting Cigna Medicare Advantage's Risk Adjustment program for assigned populations in ... of Cigna Medicare 's programs specific to CMS Risk Adjustment and HCC Coding Processes. It...Adjustment Manager, support the training and development of Senior Analysts and Lead Representatives. + Responsible for identifying… more
- Providence (NM)
- …for our Medicare Advantage plans + Have a deep understanding of Medicare Advantage regulations, risk adjustment methodologies, and a strong analytical ... must empower them._** **Providence Health Plan is calling a Senior Actuarial Analyst, Medicare Bid who will:**...the pricing process + Staying informed of changes in risk adjustment methodologies and assess their implications… more
- The Cigna Group (Miramar, FL)
- …experience or direct health plan experience with STARS, HEDIS, Risk Adjustment and medical expense reduction, specific to Medicare Advantage required + ... Market Provider Performance, Sales, Health Services, Clinical, Stars & Risk Adjustment , Finance, Marketing, Cross-Segment Contracting, Provider Relations,… more
- The Cigna Group (Houston, TX)
- …experience or direct health plan experience with STARS, HEDIS, Risk Adjustment and medical expense reduction specific to Medicare Advantage required + ... on topics including, but not limited to: preventative and quality outcome metrics, risk adjustment , medical cost management, etc. + Schedules, prepares for and… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** Supports Risk Adjustment & Stars organization to optimize Risk Adjustment revenue and coding accuracy through ... populations. Responsible for developing performance monitoring reports and analytics related to Risk Adjustment & Stars programs and processes. We are looking… more
- The Cigna Group (Memphis, TN)
- …or Memphis, TN area** **Job Summary:** This role is responsible for supporting Cigna Medicare Advantage's Risk Adjustment & Stars program for assigned ... matrix partners of Cigna Medicare 's programs specific to CMS Risk Adjustment and HCC Coding Processes. It will require expertise in ICD-10-CM/outpatient and… more
- AdventHealth (Maitland, FL)
- …regulations related to data submission for Medicare Advantage, MMP, and Marketplace risk adjustment . + Knowledge of CMS response files including RAPS, RAPS ... incentive programs, and develop and lead a broad and diversified range of risk adjustment coding services for the AdventHealth Population Health Ri Clinical… more
- Providence (Portland, OR)
- …Demonstrated expertise in budgeting and forecasting techniques. + Demonstrated knowledge in risk adjustment models (commercial, ACA, Medicare , and Medicaid) ... budgeting, projecting provider risk sharing and alternative payment amounts, and estimating risk adjustment and risk transfer payment amounts. + Key… more
- The Cigna Group (Charlotte, NC)
- …Market Provider Performance, Sales, Health Services, Clinical, Stars & Risk Adjustment , Finance, Marketing, Cross-Segment Contracting, Provider Relations, ... market strategy, compliance, and delegation oversight. + Supporting Stars & Risk Adjustment initiatives through local Provider Performance initiatives.… more
- Martin's Point Health Care (Portland, ME)
- …on estimates for Risk Revenue. Monitor changes and updates to the risk adjustment approach employed by CMS. + Prepare and analyze monthly estimates ... for Medicare Part D Risk Corridor and Coverage...Quality Management, Program Integrity, Corporate Planning, etc. + Support senior management (Chiefs and VPs) with special projects and… more
- VIP Care (Tampa, FL)
- …Electronic Medical Record (EMR) system to review Patient records + Proficiency in Medicare Risk Adjustment + Effective communication and interpersonal skills ... Summary/Objective: The Senior Medical Director is responsible for leading efforts...performance improvement strategies to ensure success in our existing ( Medicare Advantage) as well as net new LOBs. They… more
- The Cigna Group (Atlanta, GA)
- …(which includes Market Provider Performance, Sales, Clinical Operations, Stars & Risk Adjustment , Finance , Cross-Segment Contracting, Provider Relations, and ... local office 3 days per week.** The Provider Performance Senior Advisor is an integral part of a cross-functional,...and/or operational issues with providers. + Leading Stars & Risk Adjustment outcomes through local Provider Performance… more
- Point32Health (Canton, MA)
- …develop a best-in-class service model for providers.** **Identifies and executes risk adjustment strategies/initiatives to create incremental savings for ... are at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Senior Vice President, Network is responsible for leading network strategy and… more