- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Risk Adjustment Compliance Professional 2 supports the organization's ... guidance, and sound judgement in determining appropriate actions within established framework. The Risk Adjustment Compliance Professional 2 contributes… more
- Humana (Columbus, OH)
- **Become a part of our caring community and help us put health first** The Risk Adjustment Coding Professional conducts quality assurance audits of medical ... Centers for Medicare and Medicaid Services (CMS) and other government agencies. The Risk Adjustment Coding Professional work assignments are often… more
- Trinity Health (Columbus, OH)
- …diagnoses using Hierarchical Condition Category (HCC) coding methodologies. This role ensures compliance with industry standards, risk adjustment guidelines, ... diagnoses using Hierarchical Condition Category (HCC) coding methodologies. This role ensures compliance with industry standards, risk adjustment guidelines,… more
- Highmark Health (Columbus, OH)
- …This job provides end-to-end management, delivery and support to new and existing Risk Adjustment Programs. The incumbent will deliver value to the Health ... business outcomes and achieve strategic objectives relative to new and existing Risk Adjustment Programs. Supports other key objectives designed to… more
- Amazon (Lockbourne, OH)
- …at the right time and cost. We expertly navigate increasing regulatory compliance complexity to mitigate risk , increase predictability and earn trust ... stakeholders. Basic Qualifications - Bachelor's degree or equivalent - 6+ years of compliance , audit or risk management experience - Knowledge of Microsoft… more
- Datavant (Columbus, OH)
- …The individual will provide superior quality by performing audits pertaining to risk adjustment coding efforts. The individual will be responsible for ... ensuring coding compliance and accuracy + Monitor the performance of the Risk Adjustment Operations both internally and with coding vendors + Provides… more
- RELX INC (Dayton, OH)
- …matter expertise for Transaction Monitoring (TM) initiatives across the Financial Crimes Compliance (FCC) division of LexisNexis Risk Solutions. In this role, ... About the Business LexisNexis Risk Solutions is the essential partner in the...all functions including product, technology, data operations, marketing, and professional services to ensure an end-to-end focus for data,… more
- CenterWell (Columbus, OH)
- …efficiencies, processes, education, and compliance as it relates to Medicare Risk Adjustment . Uses data-based insight to direct process improvement efforts ... and Finance Strategy Lead - MRA in the PCO risk adjustment area implements and supports strategy...we allow employees to invest in their personal and professional well-being, all from day one. **Equal Opportunity… more
- GE Aerospace (Evendale, OH)
- … certification is a plus + General knowledge of legal, regulatory and compliance requirements + Broad exposure/expert in audit/ risk management + Excellent ... the audit process for a portfolio of audits, including risk assessment, planning, audit execution and reporting results for...the next, to assist with end-to-end remediation and strategic adjustment . * Oversee the development of a team of… more
- Amazon (Columbus, OH)
- …equivalent Preferred Qualifications - - Professional auditing qualification, or similar risk or compliance credentials as well as experience with research ... there's nothing we can't achieve. Basic Qualifications - 4+ years of compliance program management, legal, governance, audit, risk /loss prevention, or equivalent… more
- RELX INC (Dayton, OH)
- About the Business:LexisNexis Risk Solutions is the essential partner in the assessment of risk . Within our Government vertical, our solutions assist government ... decisions to enhance investigations. You can learn more about LexisNexis Risk at the link below. https:// risk .lexisnexis.com/governmentAbout the Role:The VP… more
- RELX INC (Dayton, OH)
- …tight deadlines and produce high quality work + Previous experience with LexisNexis Risk Solutions, LexisNexis Legal & Professional and/or other RELX companies ... About the Business: LexisNexis Risk Solutions is the essential partner in the...signatures + Works with proposal response team to ensure compliance with governmental requirements + Fast completion of government-agency… more
- Actalent (Harrison, OH)
- …environmental, health, and safety (EHS) initiatives. This position ensures compliance with all applicable EHS regulations while promoting continuous improvement ... strict adherence to applicable EHS regulations and company policies. + Ensure compliance with critical Health & Safety programs, including Chemical Process Safety… more
- RELX INC (Dayton, OH)
- About the Business LexisNexis Risk Solutions is the essential partner in the assessment of risk . Within our Business Services vertical, we offer a multitude of ... Laundering/Counter Terrorist Financing, Identity Authentication & Verification, Fraud and Credit Risk mitigation and Customer Data Management. You can learn more… more
- Sedgwick (Columbus, OH)
- …in active job search and/or during retention activities and monitors client compliance through follow-up contacts with employers. + Provides services such as resume ... and cover letter writing, career counseling, adjustment counseling, or vocational evaluations based on credentialing required by referral source. + Works with… more
- Amazon (Brooklyn, OH)
- …sites within their region to execute company safety policies and ensure compliance to all applicable local and regional regulations. By leveraging lean principles ... lead continuous improvement initiatives to reduce conditional and ergonomic risk in our processes to ensure a safe and...company policy. - Provide guidance and oversight to ensure compliance to all applicable Amazon WHS Policies. - Measure… more
- Amazon (Columbus, OH)
- …and implementing AWS's global environmental programs. This includes defining and implementing risk management and compliance systems and driving their continuous ... who want to help. Join a diverse, dynamic, and enthusiastic team of environmental compliance professionals who play a leading role in air quality permitting and … more
- CenterWell (Columbus, OH)
- …in value-based care, especially Medicare Advantage, with familiarity of HEDIS/STARS, medical risk adjustment , and clinical programming in primary care, complex ... our associates in becoming happier, healthier, and more productive in their professional and personal lives. We promote lifelong well-being by giving our associate… more
- reveleer (OH)
- …plans across all business lines greater control over their Quality Improvement, Risk Adjustment , and Member Management programs. With one transformative ... retrieval and review services so health plans can confidently plan and execute risk , quality, and member management programs to deliver more value and improved… more
- Travelers Insurance Company (Cleveland, OH)
- …reserving, litigation management, negotiation and resolution) including maintaining full compliance with internal and external quality standards and state specific ... for specific activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators, and other… more