- Elevance Health (Mason, OH)
- …and problem-solving, critical thinking skills strongly preferred. + Healthcare business knowledge related to Risk Adjustment Payment Methodology ... to the development and implementation of strategic initiatives aimed at improving risk adjustment outcomes. + Monitor the effectiveness of implemented solutions… more
- Elevance Health (Mason, OH)
- …+ Working knowledge of Medicare is strongly preferred + Healthcare business knowledge related to Risk Adjustment Payment Methodology strongly ... effectively consult and guide internal stakeholders on effective use and interpretation of risk adjustment data and KPIs + Provides expertise to lower-level… more
- Datavant (Columbus, OH)
- …to realize our bold vision for healthcare . **What we're looking for:** The incoming Risk Adjustment Analytics Manager will be stepping into a role on the ... Business Analytics team and overseeing a core group of...positioned to help create solutions + Stay informed of risk adjustment and healthcare industry… more
- Datavant (Columbus, OH)
- … risk adjustment charts + Understanding of Medicare, Commercial and Medicaid risk adjustment business logic and coding + Knowledge and understanding ... vision for healthcare . We're looking for a Risk Adjustment Trainer to help us uplevel...members of Ciox team + Expertise and understanding of risk adjustment business logic +… 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 ... and deliver large and small scale projects that advance business outcomes and achieve strategic objectives relative to new...and achieve strategic objectives relative to new and existing Risk Adjustment Programs. Supports other key objectives… more
- Humana (Columbus, OH)
- …community and help us put health first** The Director, Risk Adjustment Strategy Advancement will provide business intelligence and strategic planning support ... segments and the company at large. The Director, Risk Adjustment Strategy Advancement requires an in-depth...for a seasoned leader to lead strategic planning and business management for the team. The primary objective of… more
- Humana (Columbus, OH)
- …+ Demonstrating an understanding of departmental and organizational goals and how risk adjustment compliance supports boarder business priorities. Making ... caring community and help us put health first** The Risk Adjustment Compliance Professional 2 supports the...benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also… more
- Molina Healthcare (OH)
- …Azure, AWS, or Hadoop + 3-5 years of experience in Analysis related to HEDIS and/or Risk Adjustment + 3-5 years of experience in working with complex data to ... **Job Description** **Job Summary** The Sr Analyst, Risk and Quality Reporting role supports Molina's ...for the assigned state + Works in an agile business environment to derive meaningful information out of complex… more
- Premier Health (Dayton, OH)
- …Degree Licensure/Certification/Registration **Current Ohio Registered Nursing License** Certification in Healthcare Risk Management (CPHRM) or Associate in ... claims management and litigation management. The incumbent functions as a critical risk management resource in an integrated healthcare delivery system by… more
- Trinity Health (Columbus, OH)
- …to established timelines. + Knowledge of health plan operations (claims, revenue, or risk adjustment ) preferred. + Advanced MS Excel skills. + Experience working ... We're dedicated to providing excellent customer service, cost-effective care, and exceptional healthcare coverage. We rely on talented colleagues in a wide variety… more
- Molina Healthcare (Cleveland, OH)
- …regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... of sanctions from Medicaid or Medicare. **PREFERRED EDUCATION:** Master's in Business Administration, Public Health, Healthcare Administration, etc. **PREFERRED… more
- Molina Healthcare (Cleveland, OH)
- …**Preferred License, Certification, Association** Six Sigma Certification PMI Certification Business Analytics/ Risk Management Workforce Certification To all ... deploy workforce management strategies nationwide. Partner with leaders by strategically identifying business needs, and propose solutions in line with the needs of… more
- CenterWell (Columbus, OH)
- …entities within the Primary Care Organization. **Strategy:** + In partnership with AVP, Risk Adjustment and AVP, MRA Strategy, responsible for driving ongoing ... (APD) tool) + Responsible for performance management and strategy development for PCO risk adjustment at the division and market level; Partners with Clinical… 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 daily ... in health data exchange. Our vision is that every healthcare decision is powered by the right data, at...compliance and accuracy + Monitor the performance of the Risk Adjustment Operations both internally and with… more
- CenterWell (Columbus, OH)
- …first** The Market Partnership and Finance Strategy Lead - MRA in the PCO risk adjustment area implements and supports strategy and targeted initiatives aimed at ... processes, education, and compliance as it relates to Medicare Risk Adjustment . Uses data-based insight to direct...trends and develops internal initiatives to meet the ever-evolving business needs. Stays on the cutting age of technology… more
- RELX INC (Dayton, OH)
- About the Business : LexisNexis Risk Solutions is the essential partner in the assessment of risk . Within our Healthcare vertical, our solutions focus on ... transforming operations and improving health outcomes across the healthcare industry. While our solutions are centered around robust data assets, we also leverage… more
- Datavant (Columbus, OH)
- …BS degree in business , technology or related field + Knowledge of healthcare industry, payment models, risk adjustment , medical coding, physician ... in health data exchange. Our vision is that every healthcare decision is powered by the right data, at...between internal resources and customers in support of custom risk adjustment projects and reports on project… more
- Elevance Health (OH)
- …medical terminology and anatomy strongly preferred. + Experience with the most current CMS Risk Adjustment Model strongly preferred. + AAPC Certified Risk ... the Elevance Health family of companies, within our Carelon business . CareBridge Health exists to enable individuals in home...dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with… 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 ... and welcoming environment for all. PCO-IPA Our Independent Practice Association business consists of 182 affiliate organizations, 13,000 providers taking care of… more
- Evolent (Columbus, OH)
- …knowledge of Medicare claims, episode and condition groupers, case/episode and risk adjustment , patient attribution methodologies, and network analysis and ... selves to work. That's one reason why diversity and inclusion are core to our business . Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:**… more