- Humana (Providence, RI)
- …part of our caring community and help us put health first** The Director, Risk Adjustment Strategy Advancement will provide business intelligence and ... business segments and the company at large. The Director, Risk Adjustment Strategy Advancement requires...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- Datavant (Providence, RI)
- …+ Knowledge and understanding of HCC mapping and models + Experience with coding Medicare , Commercial and Medicaid risk adjustment charts + Understanding of ... Medicare , Commercial and Medicaid risk adjustment business logic and coding +...other legally protected status. At Datavant our total rewards strategy powers a high-growth, high-performance, health technology company that… more
- Centene Corporation (Providence, RI)
- … Medicare contract models, incorporating CMS and NYSDOH guidelines related to risk adjustment , quality metrics, and financial benchmarks. + Collaborate with ... with Contract management and Service Fund teams to implement monitoring of Medicare -specific VBP contracts, including models with upside/downside risk , shared… more
- CenterWell (Providence, RI)
- …at increasing clinical efficiencies, processes, education, and compliance as it relates to Medicare Risk Adjustment . Uses data-based insight to direct ... The Market Partnership and Finance Strategy Lead - MRA in the PCO risk adjustment area implements and supports strategy and targeted initiatives aimed… more
- CenterWell (Providence, RI)
- …within the Primary Care Organization. ** Strategy :** + In partnership with AVP, Risk Adjustment and AVP, MRA Strategy , responsible for driving ongoing ... Documentation (APD) tool) + Responsible for performance management and strategy development for PCO risk adjustment...up to 20% **Preferred Qualifications** + Proven experience with Medicare Advantage risk adjustment functions.… more
- CenterWell (Providence, RI)
- …care, especially Medicare Advantage, with familiarity of HEDIS/STARS, medical risk adjustment , and clinical programming in primary care, complex care, ... strong emphasis on senior-focused primary care for members of Medicare Advantage health plans and is committed to providing...develop and support the MSO's National Clinical Vision and Strategy , directly lead a team of regional & area… more
- Evolent (Providence, RI)
- …of Medicare claims, episode and condition groupers, case/episode and risk adjustment , patient attribution methodologies, and network analysis and pod ... to be reliable, be an excellent teammate, and contribute to our culture and strategy . **What You'll Be Doing:** + Participate in design and scoping of analytic work;… more