- CareFirst (Baltimore, MD)
- …actionable reports to solve problems, provide data-driven guidance, and monitor risk adjustment performance. Provide analytical support on various ... optimize data and analytic processes as well as reporting. Provide programming support to extract and analyze data from...developing materials and presenting key updates to leadership regarding risk adjustment programs and provider … more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Specialist supports prospective risk adjustment via concurrent review and supplemental ... data CMS filing, HHS- Risk Adjustment Data Validation (RADV) audit and...information to management team to further enhance quality and/or provider education . Work with leadership and third-party… more
- CenterWell (Annapolis, MD)
- …+ Must possess an active RN license + A minimum five years' experience in risk adjustment coding, auditing, and/or education , working with providers + CPC ... of two years' leadership experience + Knowledge of EMR + In-depth knowledge of risk adjustment key performance indicators + Comprehensive knowledge of MS Word,… more
- Baylor Scott & White Health (Annapolis, MD)
- …provider audits and creates provider scorecards to offer feedback on Risk Adjustment Methodology + Interprets health record documentation to code and ... strategies and processes for lines of business subject to risk adjustment . **SALARY RANGE** The pay range...vary based upon position type and/or level **QUALIFICATIONS** + EDUCATION - Associate's or 2 years of work experience… more
- Highmark Health (Annapolis, MD)
- … Risk Adjustment coding including documentation improvement, provider education , analyzing reports, and identifying process improvements. **ESSENTIAL ... anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation (RADV) Audits. Works closely with… more
- Conviva (Annapolis, MD)
- …collaboration with healthcare providers + Medical record review knowledge + Medicare Risk Adjustment knowledge + Extensive knowledge of coding guidelines (ie ... to divisional clinical educators. Clinical Coding Educator identifies opportunities to improve provider documentation and creates an education plan tailored to… more
- University of Maryland, Baltimore (Baltimore, MD)
- …the State of Maryland. * ** *Primary Duties - Social Worker:* * Assess risk by screening and interviewing clients. Identify and construct service plans that best ... health, poverty, unemployment, substance abuse, physical abuse, rehabilitation, social adjustment , child care, and/or medical care in accordance with licensure.… more
- CareFirst (Baltimore, MD)
- …financial and incentive models. Strategizes alternatives and solutions to maximize payments and risk adjustment . Translates from claim language to services in an ... Certified Coder (CCS or CPC)-AHIMA or AAPC **Experience:** 3 years experience in risk adjustment coding, ambulatory coding and/or CRC coding experience in… more
- RELX INC (Annapolis, MD)
- About the Business LexisNexis Risk Solutions is the essential partner in the assessment of risk . Within our Business Services vertical, we offer a multitude of ... Laundering/Counter Terrorist Financing, Identity Authentication & Verification, Fraud and Credit Risk mitigation and Customer Data Management. You can learn more… more
- University of Maryland, Baltimore (Baltimore, MD)
- …partnerships between grassroots, non-profits, city agencies, and institutes of higher education by engaging in service provision, education , and research. ... evaluation, and advocacy to maximize the individual's well-being. * Assess risk by screening and interviewing clients. Identify and construct service plans… more
- Banner Health (MD)
- …required. Experience normally obtained with 2-3 year experience in CMS HCC Risk Adjustment payment methodology and coding and documentation requirements. Must ... Salary Range:** $26.29 - $39.44 / hour, based on education & experience In accordance with State Pay Transparency...healthcare systems in the country; and the leading nonprofit provider of hospital services in all the communities we… more
- Baylor Scott & White Health (Annapolis, MD)
- **JOB SUMMARY** The Risk Adjustment Analyst Sr (Texas Medicaid Encounter Analyst) is responsible for monitoring and oversight of the end-to-end encounter ... management workflow. Supports program management activities around risk adjustment data management and submissions to government agencies such as Centers for… more
- CareFirst (Baltimore, MD)
- …expertise, drives the company-wide Quality Management program (including CMS Stars and risk adjustment ), and the ongoing development and implementation of health ... programs in a health plan/payor environment, with solid understanding of Stars and risk adjustment . + Prior experience with operations management. + Previous… more
- Humana (Annapolis, MD)
- …focus on supporting Humana's senior-focused primary care operations including: + Support risk adjustment activities and reviews, including ongoing support of the ... full compliance with applicable laws and regulations, and protection against external risk . **Use your skills to make an impact** **Required Qualifications** + Juris… more
- Actalent (Gaithersburg, MD)
- …limited to: * Responsible for creating and maintaining Process Flow Diagrams, Risk Assessments, Asset Standardization, and Master Specification Sheets. * Support the ... Responsible for the development of P&ID's and Process Flow Diagrams. * Provide technical input for analysis of process changes. Skills: Manufacturing process,… more
- Aerotek (Hanover, MD)
- …financial and performance reporting, compensation, and Ad hoc analysis. Mitigates company risk through collaboration with sales teams and field partners to ensure ... per the 1/24 rule [respond within one (1) hour, provide resolution within twenty four (24) hours]. + Primary...functional level all policies and guidelines. + Mitigates company risk through collaboration with sales teams and field partners… more
- University of Maryland, Baltimore (Baltimore, MD)
- …and concepts of a professional discipline normally acquired through advanced education or specialized training. The selected candidate resolves issues and ... between grassroots, non-profits, city agencies, and institutes of higher education by engaging in accessing resources, removing barriers, making connections,… more
- University of Maryland, Baltimore (Baltimore, MD)
- …and Orthopedics Institute (UMROI). The CCAND functions to evaluate and provide comprehensive care to adult individuals with autism, intellectual disability, and ... evaluation, and advocacy to maximize he individual's well-being. * Assess risk by screening and interviewing clients. Identify and construct service plans… more
- HUB International (Ellicott City, MD)
- …owned global insurance broker, providing a broad array of property, casualty, risk management, life and health, employee benefits, investment and wealth management ... Notice or, to Warm Transfer / release insurer claims 800 line. + Provide follow up with claim acknowledgments and adjuster assignments. + Refer emergency restoration… more
- KBR (Fulton, MD)
- …role.Periodic onsite training days will also occur, may require a temporary adjustment to the team hybrid work schedule. Subcontracts Administrator Job Description: ... Uses experience and problem-solving skills to develop and improve processes. May provide guidance to less experienced team members. Skills required for this job… more