- Baylor Scott & White Health (Providence, RI)
- + **JOB SUMMARY** The Risk Adjustment Analyst Sr is responsible for monitoring and oversight of the end-to-end encounter management workflow. This position ... to provide insight to decision-makers. This role supports program management activities around risk adjustment data management and submissions to CMS. This role… more
- Fallon Health (Worcester, MA)
- …Business, Healthcare, or Information Systems **Experience:** + 7-10+ years' experience in the risk adjustment and Medicare managed care environment + ... on Facebook, Twitter and LinkedIn. **Brief summary of purpose:** The Senior Director of Risk Adjustment is responsible for the execution and oversight of risk… more
- Datavant (Providence, RI)
- …improve productivity and quality.** + Run various risk adjustment models for Medicare Advantage, Medicaid or ACA to forecast patient risk scores and ... SQL queries, MS Excel, Python, etc + Deep understanding of and experience in Risk Adjustment (MA, ACA and MD) business analytics with knowledge of different … more
- Highmark Health (Providence, RI)
- …in the organization's value-based reimbursement programs. Strong knowledge of risk adjustment methodologies and reporting/regulatory requirements and CMS ... share models and will be implemented for the Organization's Medicare Advantage, Medicaid, ACA , and commercial populations...outcomes strategic plan development. + 1 year experience with Medicare STARS, Medicaid HEDIS, risk revenue value… more