- Humana (Des Moines, IA)
- …+ Experience in healthcare operations, preferably with exposure to MRA or risk adjustment + Strong understanding of financial concepts (budgeting, ROI, ... us put health first** This role will support ongoing performance evaluation and enhancement for STP initiatives, while also...cost management ) + Proficient Excel skills; familiarity with business intelligence… more
- Molina Healthcare (Des Moines, IA)
- …Risk Adjustment submissions data to evaluate healthcare intervention program performance . Develops and presents Risk Adjustment intervention ROI, ... Services (SSIS), and other analytic / programming tools as needed + Reporting includes Risk Adjustment program performance metrics, risk score and… more
- Elevance Health (West Des Moines, IA)
- …historical program performance and to inform current operating decisions. + Prepares management reports for risk adjustment related projects. + Collects ... **Medicare Risk Adjustment Actuarial Analyst III** **On-Site Requirement: Hybrid 1;** **This role requires associates to be in-office 1 - 2 days per week,**… more
- Datavant (Des Moines, IA)
- …to realize our bold vision for healthcare. **Role Overview** As a Product Manager, Risk Adjustment Analytics Products, you will contribute to the strategy and ... execution of analytics capabilities that power Datavant's risk adjustment solutions. You'll drive the development of robust, scalable, and actionable analytics… more
- Datavant (Des Moines, IA)
- …planning and management of workloads, communication with stakeholders, and the risk adjustment subject matter expertise necessary to be operating proactively ... vision for healthcare. **What we're looking for:** The incoming Risk Adjustment Analytics Manager will be stepping...analytics + Experience using Jira for workflow and project management + Experience using both Microsoft and Google office… more
- Datavant (Des Moines, IA)
- …strategic mindset and a focus on continuous improvement. + Familiarity with CMS HCC risk adjustment processes preferred \#LI-BC1 We are committed to building a ... to escalate and create solutions. + Own client operations project management processes, tools, reference materials, and cross‐functional usage. + Identify, define,… more
- Datavant (Des Moines, IA)
- …for healthcare. The Coding Supervisor serves as a working supervisor with oversight and management of Risk Adjustment team members. This includes monitoring ... lives we impact. You will: + Supervise day-to-day team performance , conduct 1:1's and performance assessments. +...findings on a daily basis, including education on time management and best coding practices. + Provide coaching and… more
- Molina Healthcare (Des Moines, IA)
- …**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** * 2+ years of program and/or project management experience in risk adjustment and/or quality * 2+ ... **Job Description** **Job Summary** The Risk & Quality Performance Manager position...years of experience supporting HEDIS engine activity, risk adjustment targeting and reporting systems *… more
- CenterWell (Des Moines, IA)
- …(including Annual Proof of Documentation (APD) tool) + Responsible for performance management and strategy development for PCO risk adjustment at the ... entities within the Primary Care Organization. **Strategy:** + In partnership with AVP, Risk Adjustment and AVP, MRA Strategy, responsible for driving ongoing… more
- Datavant (Des Moines, IA)
- …+ Play a key role in ensuring coding compliance and accuracy + Monitor the performance of the Risk Adjustment Operations both internally and with coding ... The individual will provide superior quality by performing audits pertaining to risk adjustment coding efforts. The individual will be responsible for… more
- Datavant (Des Moines, IA)
- …coding teams deliver on them through collaboration with those responsible for coder performance management . + Drive quality assurance and performance ... Apixio's products, how to effectively use Apixio's coding and management tools, and ensuring alignment on coding quality. +...clients understand the shifts and trends happening in the risk adjustment coding space. **What you will… more
- Molina Healthcare (Des Moines, IA)
- …of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), ... multiple Molina Healthcare products. Designs and develops reports to monitor health plan performance and identify the root causes of medical cost trends. With those… more
- Amazon (Bondurant, IA)
- …to the role * 7+ years of increasing responsibilities in people and performance management * CPR/First Aid Certification, or willingness to obtain within ... you will lead continuous improvement initiatives to reduce conditional and ergonomic risk in Amazon's processes to ensure a safe and healthful working environment… more
- Travelers Insurance Company (Des Moines, IA)
- …compensation and benefits program, employees are also eligible for performance -based cash incentive awards. **Salary Range** $129,200.00 - $213,200.00 **Target ... service on assigned claims, while engaging in indemnity & expense management . Promptly manage claims by completing essential functions including contacts,… more
- Humana (Des Moines, IA)
- …analyze large data sets + Knowledge of healthcare compliance, mainly primary care and risk adjustment , pharmacy knowledge a plus + Certified Coder (CPC, CRC, ... to assess, investigate, audit and validate the mitigation of compliance risk across the organization. This team ensures that healthcare providers align… more
- Sedgwick (Des Moines, IA)
- …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 ... Strong customer service skills + Attention to detail and accuracy + Good time management and organizational skills + Ability to work independently or in a team… more
- Sedgwick (Des Moines, IA)
- …regardless of size, including having the ability to address any complex adjustment issue and any medium sized and relatively complex National Account. **ESSENTIAL ... Strong customer service skills + Attention to detail and accuracy + Good time management and organizational skills + Ability to work independently or in a team… more
- Bristol Myers Squibb (Des Moines, IA)
- …of BMS products while also focusing on overall business results and performance objectives while exemplifying BMS values. The Institutional MHAS role is field-based ... of formulary, reimbursement processes + Demonstrated strong capability in account management skill sets, superior selling competencies, and proven sales … more
- Molina Healthcare (Des Moines, IA)
- …applications -_** **which underpin essential business functions such as HEDIS reporting, Risk Adjustment (RA), and Health Plan Reporting.** + **_Azure ... processes. Applies and promotes key principles (eg stability, scalability, performance , security, compatibility, re-use), helping ensure a balance between tactical… more