- Datavant (Augusta, ME)
- …realize our bold vision for healthcare. **Role Overview** As the Director of Prospective + Concurrent Risk Adjustment Products, you will lead the ... in industry conversations on emerging regulations and best practices related to prospective risk capture and concurrent review. **Compliance & Quality:** +… more
- SMBC (Jersey City, NJ)
- …a competitive portfolio of benefits to its employees. **Role Overview:** Reporting to the Director Operational Risk , the Director will provide the 2nd Line ... RMDAD implements a non-financial risk framework independent of the businesses' risk appetite statements. The Director is responsible for supporting the 2nd… more
- Ankura (New York, NY)
- …list creation, Risk Adjustment vendor audit processes, managing retrospective or prospective Risk Adjustment activities such as Chart Review or In-Home ... investigations, and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment. The Senior Director will also support practice… more
- SMBC (Charlotte, NC)
- …portfolio of benefits to its employees. **Role Description** Reporting to the Operational Risk Officer, Director of Operational Risk , the position supports ... the Second Line of Defense Risk Management Department Americas Division's (RMDAD) Non-Financial ...project management skills, with ability to successfully manage multiple concurrent priorities. + Strong written and verbal communication skills.… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …to working eastern time zone hours.** **Essential Job Functions** + Oversees prospective , concurrent , and retrospective chart reviews for diagnosis coding ... and operational excellence. **Primary Function/General Purpose of Position** The Risk Score Accuracy (RSA) Program Manager provides leadership, oversight,… more
- Bon Secours Mercy Health (Cincinnati, OH)
- …the Hierarchical Condition Categories (HCC) coding program. This role coordinates prospective , concurrent and retrospective chart reviews for diagnosis coding ... for performance improvement related to system-wide RSA and HCC and other risk adjustment coding initiatives. Works with HCC Coding Supervisor and System … more