- Baylor Scott & White Health (Austin, TX)
- + **JOB SUMMARY** The Risk Adjustment Analyst Sr is responsible for monitoring and oversight of the end-to-end encounter management workflow. This position ... to provide insight to decision-makers. This role supports program management activities around risk adjustment data management and submissions to CMS. This role… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …be considered. * Experience in medical coding with a focus on Medicare Advantage and ACA risk adjustment . * Certified Risk Adjustment Coder (CRC) ... certification * In-depth knowledge of ACA & Medicare Advantage risk adjustment methodology, coding guidelines (ICD-10-CM), healthcare compliance, and… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Medicare Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and ... integrity of key risk adjustment performance metrics through coordination of...and MS Access Database. + Experience with EDGE & ACA or Medicaid risk score methodology, including… more
- Fallon Health (Worcester, MA)
- …Business, Healthcare, or Information Systems **Experience:** + 7-10+ years' experience in the risk adjustment and Medicare managed care environment + ... on Facebook, Twitter and LinkedIn. **Brief summary of purpose:** The Senior Director of Risk Adjustment is responsible for the execution and oversight of risk… more
- CareFirst (Baltimore, MD)
- …to ensure that all risk adjustment activities fully comply with Medicare , Medicaid, ACA , and state-specific regulations. Remain current on changes to ... **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Operations Supervisor supports...supports the execution of the corporate coding strategy across Medicare Advantage, Medicaid, and ACA markets. This… more
- University of Utah Health (Murray, UT)
- …lines of business (eg, ACA , Medicaid). + Supports the evaluation of risk adjustment interventions such as provider outreach, chart reviews, and in-home ... trust that are integral to our mission. EO/AA_ + Risk Adjustment Analyst position provides support for...targeting data to identify opportunities for accurate and complete risk score capture in ACA (Marketplace), and… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …skills, and military experience will be considered. * Extensive knowledge of CMS risk adjustment regulations, HHS ACA requirements, Medicaid risk ... characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Director of Risk Adjustment Location: Hybrid | Eagan, Minnesota Career Area: Special… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Manager plays a critical role in the development and execution of the corporate risk adjustment ... the end to end strategy by applying improvements and driving cost-effective risk adjustment actions across all organizational populations and products.… more
- Molina Healthcare (Cincinnati, OH)
- …Director level role or above. + Extensive understanding of Medicare Advantage, ACA and Medicaid risk adjustment processes, including encounter data ... **Job Description** **Job Summary** The AVP, Risk Adjustment Encounters is responsible for...processes that track, evaluate, and submit encounter deletions for Medicare Advantage, ACA , and Medicaid lines of… more
- Highmark Health (Montpelier, VT)
- …in the organization's value-based reimbursement programs. Strong knowledge of risk adjustment methodologies and reporting/regulatory requirements and CMS ... share models and will be implemented for the Organization's Medicare Advantage, Medicaid, ACA , and commercial populations...outcomes strategic plan development. + 1 year experience with Medicare STARS, Medicaid HEDIS, risk revenue value… more