- Providence (Portland, OR)
- …of WA, OR and CA. **The Role:** As the Director of Risk Adjustment and Strategic Accounts at Providence Health Plan, you will be the cornerstone of our ... strategic vision. You will oversee risk adjustment programs, spearhead provider education, and...ideas to life. + **Advocacy & Impact:** Represent Providence Health Plan in advocacy, shaping the future of healthcare… more
- Molina Healthcare (Vancouver, WA)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... **JOB DESCRIPTION** **Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization...EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in… more
- Molina Healthcare (Vancouver, WA)
- …experience with proven relationship management responsibilities * Proven experience in risk adjustment , quality, and provider engagement. * Demonstrated ability ... Risk & Quality Solutions (RQS) works with health plan risk & quality leaders to...**PREFERRED EXPERIENCE:** 10+ years managed care experience specifically within Risk Adjustment and/or Quality To all current… more
- Molina Healthcare (Vancouver, WA)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, Medicaid,… more
- Molina Healthcare (Vancouver, WA)
- …+ Coordinates accountabilities between segment and markets to drive performance in network, risk adjustment , and stars; single point of contact for escalations ... from aligned market segments. + Coordinates accountabilities between segment, health plans, and shared services to drive compliance and performance objectives as… more
- Molina Healthcare (Vancouver, WA)
- …Claims applications -_** **which underpin essential business functions such as HEDIS reporting, Risk Adjustment (RA), and Health Plan Reporting.** + **_Azure ... with project teams to find solutions to ensure the success of the Health Performance Assessment System. * Takes a leadership role in evolving Molina application… more
- Molina Healthcare (Vancouver, WA)
- **Job Description** **Job Summary** The AVP, Risk Adjustment Encounters is responsible for establishing enterprise-wide strategy, governance, and oversight of ... the integrity of enterprise revenue, and enabling the organization's overall risk adjustment strategy. Knowledge/Skills/Abilities + Responsible for encounters… more