- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- Ready to help us transform healthcare? Bring your true colors to blue. The Medicare Risk Adjustment Strategy Program Manager will report to the Senior ... Director of Medicare Risk Adjustment and Analytics....Director of Medicare Risk Adjustment and Analytics. This role will... performance that will assess the progress of the risk adjustment strategy + Develop… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …The role is responsible for the strategy , execution and performance of Medicare risk adjustment reporting and analytics, infrastructure and systems to ... Bring your true colors to blue. Under the direction of the Senior Directory of Medicare Risk Adjustment and Analytics, the Director of Risk Adjustment… more
- Datavant (Boston, MA)
- …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… more
- Datavant (Boston, MA)
- …and managing in a remote environment (2+ years) + 3+ years of experience working with Medicare , ACA, and/or Medicaid risk adjustment models + 5+ years of ... vision for healthcare. **What we're looking for:** The incoming Risk Adjustment Analytics Manager will be stepping...with other managers and the department director to set strategy and mobilize the team to be as performant… more
- CenterWell (Boston, MA)
- …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
- Datavant (Boston, MA)
- …outpatient or inpatient setting. + Current CCS, CRC, or CPC required. + Previous Medicare Advantage Risk Adjustment , CDI, Medicaid, Commercial RA, and HEDIS ... up to date with current coding policies for ICD-10, Medicare Advantage, HHS (ACA), and other markets. + Provide...clients understand the shifts and trends happening in the risk adjustment coding space. **What you will… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …delivery of high-quality, trustable clinical data to support key initiatives around quality, risk adjustment , medicare stars, and interoperability. This is a ... + Collaborate with cross-functional teams, including clinical operations, performance measurement, and risk adjustment , to execute on data procurement & usage… more
- Humana (Boston, MA)
- …/ read data sets. + Experience with Healthcare Interoperability. + Familiarity with CMS Risk Adjustment and Quality Measure Reporting. + Experience in UAT / PPV ... for development team members based on Humana's LPM (Lean Portfolio Management) strategy with a top-down value approach. + Manage technical relationships with… more
- Evolent (Boston, MA)
- …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