- Humana (Annapolis, MD)
- …for improving health outcomes and advancing the care experience of our members and provider partners. The Risk Adjustment team collects and submits members' ... Lead within the Healthcare Quality Reporting and Improvement (HQRI) organization. HQRI (comprised of Risk Adjustment and Health Quality & Stars) is responsible… more
- The Cigna Group (Baltimore, MD)
- …populations in an operational market. The role will be accountable for assigned provider groups reaching risk adjustment related annual metrics. This ... assigned market. Lead Analyst will be primary contact for provider groups on Risk Adjustment ... office diagnosis coding. Implement provider office education , where necessary, and provide formal training… more
- Lockheed Martin (Bethesda, MD)
- … education and support to the business units on workers' compensation matters\. ‒ Provide the following risk management support to the Missiles & Fire Control ... to the business units\. ‒ Manage the reporting and adjustment of claims\. ‒ Ensure compliance with all policy...M&A activity as necessary\. Respond to business units' ongoing risk management service needs; provide evidence of… more
- CareFirst (Baltimore, MD)
- …for successful delivery of objectives, on time and within budget for Retrospective Risk Adjustment Activities for Chart Retrieval and Coding within CareFirst's ... that week.** **ESSENTIAL FUNCTIONS:** + Plans and initiates retrospective risk adjustment project resources, prepares budgets, monitors progress,… more
- Humana (Annapolis, MD)
- …for improving health outcomes and advancing the care experience of our members and provider partners through integrated risk adjustment (RA) and quality ... and technology to empower members, providers, and Humana. The Risk Adjustment Prospective Provider Programs...bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office employees with telephone equipment… more
- Washington Suburban Sanitary Commission (WSSC) (Laurel, MD)
- …revenue by monitoring significantly complex accounts and expeditiously resolving all adjustment and payment issues + Monitors billing reports to ensure accounts ... and Billing Error Reports, and monitors open High Bill Adjustment Cases. + Monitors the quality and volume of...Hearing panel and WSSC Water customers. + Evaluates high risk accounts to implement recommendations for resolution. + Works… more
- University of Maryland, Baltimore (Baltimore, MD)
- …options (if applicable per job). *Primary Duties - Social Worker:* * Assess risk by screening and interviewing clients. Identify and construct service plans that ... health, poverty, unemployment, substance abuse, physical abuse, rehabilitation, social adjustment , child care, and/or medical care in accordance with licensure.… more
- Banner Health (MD)
- …required. Experience normally obtained with 2-3 year experience in CMS HCC Risk Adjustment payment methodology and coding and documentation requirements. Must ... Salary Range:** $26.29 - $39.44 / hour, based on education & experience In accordance with State Pay Transparency...healthcare systems in the country; and the leading nonprofit provider of hospital services in all the communities we… more
- University of Maryland, Baltimore (Baltimore, MD)
- …partnerships between grassroots, non-profits, city agencies, and institutes of higher education by engaging in service provision, education , and research. ... evaluation, and advocacy to maximize the individual's well-being. * Assess risk by screening and interviewing clients. Identify and construct service plans… more
- Humana (Annapolis, MD)
- …us put health first** Healthcare Quality Reporting & Improvement (HQRI) delivers integrated risk adjustment (RA) and quality (Stars) solutions that leverage data ... that help support and connect across these member and provider focused efforts. HTA's Member & Provider ...bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office employees with telephone equipment… more
- Zurich NA (Annapolis, MD)
- …and financial perspective. We work with our wellbeing partners and industry experts to provide the best advice and access to a wealth of lifestyle support. We're ... minimal travel to industry events/conferences. Working with an award-winning Risk Management team as part of a Global insurer...the opportunity to let us know of any reasonable adjustment or practical support needed when you apply. **Required… more
- University of Maryland, Baltimore (Baltimore, MD)
- …evaluation, and advocacy to maximize the individual's well-being. * Assess risk by screening and interviewing clients. Identify and construct service plans ... health, poverty, unemployment, substance abuse, physical abuse, rehabilitation, social adjustment , childcare, and/or medical care in accordance with licensure. *… more
- Guidehouse (Bethesda, MD)
- …and interventions in accordance with Social Work Department Policies and Procedures. + Provide education regarding adjustment to illness and managing ... a full-time opportunity located in Bethesda, MD. + Independently provide social work services to Clinical Center patients, families,...and (2) to assist patients in making optimal hospital adjustment for requisite time of the study and arrange… more
- Humana (Annapolis, MD)
- …+ Experience working with Medical Claims or other healthcare data + Medicare Risk Adjustment Experience + Masters Degree **Use your skills to make ... Quality Reporting and Improvement (HQRI) is responsible for projecting and tracking risk adjustable revenue. Specifically, this role projects and tracks risk … more
- Sedgwick (Annapolis, MD)
- …heart of everything we do. Caring counts** Sedgwick is a leading global provider of technology-enabled risk , benefits and integrated business solutions. Every ... Facilitates return-to-work (RTW) efforts through negotiation with client, treatment provider and claimant; completes all vocational/RTW related jurisdictional or… more
- Johns Hopkins University (Baltimore, MD)
- …data. + Provide research support on topics including cohort definition, risk adjustment scores, cost-sharing calculations, and provider -level data ... CPU usage, and file storage. _Develop expertise and cultivate shared knowledge to provide guidance on complex topics_ + Facilitate knowledge sharing among data users… more
- Humana (Annapolis, MD)
- …Financial Operations and market CFOs + Analysis of changes in capitation rates and risk adjustment methodology in order to communicate the financial impact and ... CFOs in order to support a wide variety of actuarial analysis, including: provider contracts, IBNR, vendor ROI, program and legislative change impacts + Programming… more
- RELX INC (Annapolis, MD)
- …to measure and improve client satisfaction of our products. You will provide excellent customer support and value-added services to ensure retention and renewal ... with minimal supervision to develop strategies focused on customer retention, risk mitigation strategies, and renewal maintenance. + Identifying key contacts and… more
- Humana (Annapolis, MD)
- …+ Demonstrated knowledge of Medicare Advantage program + Demonstrated knowledge of risk adjustment and the Stars quality program + Experience in ... with applicable laws and regulations, and protection against external risk . **Required Qualifications:** + Juris Doctorate, with licensing in...Please be aware that applicants may be asked to provide their Social Security Number, if it is not… more
- Aerotek (Hanover, MD)
- …financial and performance reporting, compensation, and Ad hoc analysis. Mitigates company risk through collaboration with sales teams and field partners to ensure ... per the 1/24 rule [respond within one (1) hour, provide resolution within twenty four (24) hours]. + Primary...functional level all policies and guidelines. + Mitigates company risk through collaboration with sales teams and field partners… more