- Cambia Health Solutions, Inc (Renton, WA)
- …in critical objectives such as population health management, Medicare Stars, and Risk Adjustment .Here are some of the exciting responsibilities you'll ... health management, Provider contracting and reimbursement, managed care, healthcare delivery, risk adjustment , StarsOr equivalent combination of education and… more
- Martin's Point Health Care (Portland, ME)
- …a "Great Place to Work" since 2015. Position Summary The Senior Director of Risk Adjustment Operations in our Health Plan is responsible the overall development, ... refinement, maintenance, monitoring and oversight of Medicare Risk Adjustment initiatives and operations. The Senior...for all aspects of the decision-making and implementation of medical record coding reviews and coding policies for the… more
- CVS Health (Dover, DE)
- …and affordable. Position SummaryThe Revenue Integrity (RI) Sr. Manager, Business Consultant ( Risk Adjustment ) is responsible for the management and monitoring of ... designated market/territory specific to the performance of risk adjustment (RA). The role is responsible for all aspects of driving collaborative decision-making… more
- HSBC (New York, NY)
- …all relevant risk areas eg credit risk , counterparty credit risk , securitization, and Credit Valuation Adjustment ('CVA'). GRPA currently maintains a ... ('GRPA') is responsible for establishing HSBC's Group level, and certain regional level, prudential regulatory capital policies, and for advising business lines… more
- The Cigna Group (Westerville, OH)
- …work to leadership and key stakeholders. + Provide regular updates on market and regional level risk adjustment metrics and prospective program performance, ... This role is responsible for supporting Cigna Medicare Advantage risk adjustment prospective programs, solutions, and performance in aligned operational region… more
- Bristol Myers Squibb (San Francisco, CA)
- …RAD oversees their regional team to ensure disease and product related medical needs in the region are being identified. Oversight of the MSLs' primary ... program support (if applicable) + Contributes FM expertise to regional accounts aligned to Brand and Medical ...projects and priorities + Track record of effectively managing risk and compliance + Work in a matrix environment… more
- Carle (Urbana, IL)
- …AND KNOWLEDGE Possesses the "other knowledge and skills" of the Revenue Cycle Regional Representative 1. Knowledge of basic medical coding and third-party ... Rev Cycle Regional Rep 2 + Department: Revenue Cycle -...+ On Call Requirements: No + Work Location: Methodist Medical Center + Weekend Requirements: No + Holiday Requirements:… more
- HCA Healthcare (Brentwood, TN)
- …(CPC(R)) credential or Certified Professional Coder - Hospital (CPC-H(R)) or Certified Risk Adjustment Coder (CRC) **EXPERIENCE:** + Experience with Cerner and ... **Description** This position is incentive eligible. **Introduction** The Regional Coding Operations Manager (RCOM) is responsible for assisting in the development… more
- Trinity Health (Mason City, IA)
- …experience. + Preferred: In addition, Certified E&M Coder (CEMC), including Certified Risk Adjustment Coder (CRC) or Certified Documentation Expert Outpatient ... using performance resolution process as needed. + Oversees retrospective and prospective medical record documentation audits of all regional network providers… more
- Bloomberg (Washington, DC)
- Bloomberg Economics - GeoEconomics - Country Risk Analyst **Washington, DC** Posted Mar 20, 2024 - Requisition No. 123986 With close to 50 economists and 200 ... and policy. We are seeking an expert on country risk analysis to join our growing team. **THE ROLE:**...+ A degree in economics, political science, international relations, regional studies or a related field. A graduate degree… more
- CVS Health (Columbus, OH)
- …capture. Identifies opportunities to promote quality. Shares best practices in risk adjustment across all sites/regions. Simultaneously manages multiple, complex ... ensuring accurate, timely, and quality clinical documentation in the medical record to reflect the health status of patients...- CPC AAPC or CCA AHIMA certification- 3+ years risk adjustment experience in Medicare advantage or… more
- Commander, Navy Installations (Yorktown, VA)
- Summary Serve as a Non- medical Clinical Counselor within Commander, Navy Installations Command (CNIC), Fleet and Family Readiness Department (N9), Family Readiness ... couples, families, and groups on family dynamics, parent-child interaction, adjustment to commonly occurring personal and family issues/circumstances, adjustment… more
- Molina Healthcare (Albuquerque, NM)
- …regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... for mental health and chemical dependency services. Works closely with the Regional Medical Directors to standardized utilization management policies and… more
- Centene Corporation (Jacksonville, FL)
- …Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment . Provides education for HEDIS measures, appropriate medical record documentation ... on workplace flexibility. Position will require up to 50% regional travel and candidate must reside in Jacksonville, Florida...+ Collects, summarizes, trends, and delivers provider quality and risk adjustment performance data to identify and… more
- AdventHealth (Maitland, FL)
- …in understanding professional and facility claims and managed care concepts such as risk adjustment , capitation, FFS, DRG, APG, APCs and other payment mechanisms ... at the office (Altamonte Springs,FL)** **The role you'll contribute:** A Senior Medical Economics analyst is responsible for analyzing and evaluating financial and… more
- Bristol Myers Squibb (Trenton, NJ)
- …their personal lives. Read more: careers.bms.com/working-with-us . **Position:** ** Medical Science Liaison, Neurology** **Location** **: Field - Washington/Oregon** ... The primary role of the Medical Science Liaison (MSL) is to engage in meaningful...peer-to-peer scientific dialogue with healthcare system leaders such as Regional Thought Leaders (RTLs), National Thought Leaders, and Healthcare… more
- Bristol Myers Squibb (Trenton, NJ)
- …personal lives. Read more: careers.bms.com/working-with-us . The primary role of Medical Engagement Lead (MEL) is to engage in meaningful peer-to-peer scientific ... Real-World Evidence). The role collaborates with colleagues on capturing medical insights and acts as a therapeutic area resource...office to inform strategy. This role is field-based and regional in scope. It is anticipated that the employee… more
- CVS Health (Columbus, OH)
- …treatment protocols for DSNP/MMP and other complex health populations to optimize risk adjustment , clinical quality, and care management* Actively participate in ... person as needed* Outward facing position to interact and collaborate with medical / physical professional associates, the local provider community, state regulatory… more
- Truman Medical Centers (Kansas City, MO)
- …positions and apply.** Child Therapist - Lakewood Counseling TMC Truman Medical Centers **Job Location** Lakewood Counseling Service Lees Summit, Missouri ... system for Jackson County/Kansas City. We are an academic medical center, serving as the primary teaching institution for...the 2020 pandemic, we also stepped forward as a regional leader in COVID care and testing. UH is… more
- Bristol Myers Squibb (Madison, NJ)
- …internal stakeholders across the Medical matrix (eg, the country and regional medical directors) and other Scientific Communications & Engagement team (eg, ... more: careers.bms.com/working-with-us . **Position Summary** Position reports to the Director of Medical Communications within WW Medical WWMH, Global Medical… more
