- Humana (Providence, RI)
- …+ 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
- Datavant (Providence, RI)
- …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 (Providence, RI)
- …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 (Providence, RI)
- …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
- Datavant (Providence, RI)
- …using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical ... coding accuracy rate. + Any other task requested by management . **What you will bring to the table:** +...of Datavanters who are all responsible for stewarding a high- performance culture in which all Datavanters belong and thrive.… more
- CenterWell (Providence, RI)
- …(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 (Providence, RI)
- …+ 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 (Providence, RI)
- …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
- Datavant (Providence, RI)
- …team coordinates efforts between internal resources and customers in support of custom risk adjustment projects and reports on project status to all ... technology or related field + Knowledge of healthcare industry, payment models, risk adjustment , medical coding, physician workflow, and/or electronic health… more
- Centene Corporation (Providence, RI)
- …refining Medicare contract models, incorporating CMS and NYSDOH guidelines related to risk adjustment , quality metrics, and financial benchmarks. + Collaborate ... Strong written and oral communication skills. Knowledge of population health management , medical expense and quality performance analysis preferred. **Please… more
- Travelers Insurance Company (Providence, RI)
- …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
- Travelers Insurance Company (Providence, RI)
- …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 (Providence, RI)
- …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 (Providence, RI)
- …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
- Sedgwick (Providence, RI)
- …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
- Evolent (Providence, RI)
- …decision support systems is preferred + **Background in value-based care** models, risk adjustment , and quality measurement programs is preferred + **Experience ... and health plans + Design systems that support population health management and care coordination across multiple specialties + Implement real-time data… more