- Humana (Jefferson City, MO)
- …to drive efficient, effective, and compliant risk adjustment processes. This Risk Adjustment Risk Management lead position will be responsible ... Management Lead acts as a consultant to the Risk Adjustment team leaders, as programs and...Management and is responsible for oversight of the Risk Adjustment Operations processes. The Risk… more
- Centene Corporation (Jefferson City, MO)
- …from home anywhere in the Continental United States.** **Position Purpose:** Supports the Risk Adjustment Compliance program elements, with a focus on the ... and correction of compliance issues. Facilitates and leads external audits related to Risk Adjustment processes. Ensures visibility by way of reporting out audit… more
- Centene Corporation (Jefferson City, MO)
- …the Continental United States. **Position Purpose:** Executes Line 2 oversight of Risk Adjustment activities, including monitoring, auditing, and supports Line 1 ... accurate and complete diagnosis coding in alignment with HCCs and other risk adjustment models. Identifies and evaluates clinical documentation gaps, assesses… more
- Baylor Scott & White Health (Jefferson City, MO)
- …and external sources to provide insight to decision-makers. This role supports program management activities around risk adjustment data management ... procedure documentation. + Oversee updates to department policies and procedures regarding risk adjustment data management . + Remain current on CMS Risk… more
- Datavant (Jefferson City, MO)
- …and roadmap for the Data Integration pod within the Retrospective Risk Adjustment Coding Product Suite + **Client Data Management :** Oversee secure and ... 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… more
- Datavant (Jefferson City, MO)
- …and life experiences to realize our bold vision for healthcare. As an Auditor, HCC Risk Adjustment Coder, you will review medical records to identify and code ... using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical… more
- Datavant (Jefferson City, MO)
- …vision for healthcare. We're looking for experienced and credentialed Auditing Team Lead, HCC Risk Adjustment Coding to become an integral part of our team. The ... for education opportunities in both quality and productivity to management for review and/or action. + Assists in auditing...95% or higher. + Any other tasks required by management . What you will bring to the table: +… more
- Datavant (Jefferson City, MO)
- …for healthcare. Auditing Supervisor serves as a working supervisor with oversight and management of Risk Adjustment team members. This includes monitoring ... findings on a daily basis, including education on time management and best coding practices. + Provide coaching and...the role. + Report trends for education opportunities to management for review and/or action. + Motivate team members… more
- Datavant (Jefferson City, MO)
- …using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical ... skills, problem solve, ability to work in a remote environment, and time management skills. + Working knowledge of the business use of computer hardware and… more
- Datavant (Jefferson City, MO)
- …The individual will provide superior quality by performing audits pertaining to risk adjustment coding efforts. The individual will be responsible for ... role in ensuring coding compliance and accuracy + Monitor the performance of the Risk Adjustment Operations both internally and with coding vendors + Provides… more
- CenterWell (Jefferson City, MO)
- …GenAI) + Responsible for performance management and strategy development for PCO risk adjustment at the division and market level; Partners with Clinical ... interrelate across the function or segment. **Strategy:** + In partnership with AVP, Risk Adjustment and AVP, MRA Strategy, responsible for driving ongoing… more
- Wolters Kluwer (Jefferson City, MO)
- …| Wolters Kluwer (https://www.wolterskluwer.com/en/solutions/health-language)** **Coder Workbench Solution:** ** Risk Adjustment Software | Health Language ... or Central time zone, have a solid understanding of risk adjustment in the Healthcare Technology space,...+ Provide comprehensive and insightful sales reports to senior management . + Identify and leverage market opportunities for business… more
- CVS Health (Jefferson City, MO)
- …the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical ... Coder) or CCS-P (Certified Coding Specialist-Physician) required. + CRC (Certified Risk Adjustment Coder) + Computer proficiency including experience with… more
- Amentum (Jefferson City, MO)
- …the successful development of correctional intelligence programs to assist in the management of violent extremist and high- risk offenders **REQUIRED SKILLS AND ... designed for the following purpose: Building Responsive and Effective Prison Management Systems to Repatriate, Rehabilitate, Reintegrate, and Prosecute FTFs and may… more
- Sedgwick (Jefferson City, MO)
- …regardless of size, including having the ability to address any complex adjustment issue and any medium sized and relatively complex National Account. **ESSENTIAL ... + Attention to detail and accuracy + Good time management and organizational skills + Ability to work independently...this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive… more
- Sedgwick (Jefferson City, MO)
- …unassisted up to $10M, including having the ability to address most complex adjustment issues pertaining to damages and coverage; to assist on even larger losses ... + Attention to detail and accuracy + Good time management and organizational skills + Ability to work independently...this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive… more
- Humana (Jefferson City, MO)
- …on progress, challenges, and achievements to management . + Partner with Medicare Risk Adjustment (MRA) and vendors to establish data feeds for STARs data ... and flows and uses that knowledge to design and implement master data management solutions. The Lead, Data Quality/Integrity works on problems of diverse scope and… more
- CVS Health (Jefferson City, MO)
- …metrics** , and **provider performance** + Familiarity with **claims data** , ** risk adjustment ** , or **value-based care models** + **Advanced Analytics:** ... provider efficiency, member outcomes, and the impact of medical management programs. + Collaborate with cross-functional teams, including actuaries, clinicians,… more
- Centene Corporation (Jefferson City, MO)
- …analysis, and/or ROI evaluation preferred. Familiarity with claims payment, utilization management , provider/vendor contracts, risk adjustment for government ... of experience working with large databases, data verification, and data management or 3+ years IT experience. Healthcare analytics experience preferred. Experience… more
- Centene Corporation (Jefferson City, MO)
- …analysis, and/or ROI evaluation preferred. Familiarity with claims payment, utilization management , provider/vendor contracts, risk adjustment for government ... years of experience working with large databases, data verification, and data management or 2+ years of IT experience. Healthcare analytics experience preferred.… more