- Highmark Health (Pittsburgh, PA)
- …+ Production Coding : Manage a team of internal coder / clinicians that perform Risk Adjustment coding of medical records. Track production coding ... for the Highmark Health Enterprise. Ensures that Highmark's Risk Adjustment programs comply with all applicable...coding . Promotes the strategy and capabilities to develop risk management and physician / member initiatives that support… more
- Evolent (Phoenix, AZ)
- …Be Doing:** **Manager, Coding Support Specialist** Evolent Care Partners is seeking a Risk Adjustment Coding Support Manager to be a core member of ... the Risk Adjustment Coding Support team....the Risk Adjustment Coding Support team. Evolent Care Partners'...coding questions and issues. + Collaborate with the coding director to develop policies, procedures, and… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …to ensure data integrity, accuracy, completeness and adherence to leading practices in risk adjustment coding . * Identifies external partner opportunities, ... Blue Cross and Blue Shield of Minnesota Position Title: Director of Risk Adjustment Location:...* Responsible for developing and implementing risk adjustment strategies to facilitate accurate and complete coding… more
- Datavant (Augusta, ME)
- …on identifying and acting on undiagnosed conditions (prospective suspecting) and ensuring risk adjustment coding accuracy in near real-time (concurrent ... As the Director of Prospective + Concurrent Risk Adjustment Products, you will lead the...technology solutions. + Solid understanding of clinical suspecting, concurrent coding workflows, risk adjustment models… more
- Ankura (New York, NY)
- …Risk Adjustment data collection and submission activities as well as knowledge of Risk Adjustment coding requirements preferably with a Risk ... and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment . The Senior Director will also support practice… more
- Providence (Portland, OR)
- …work mostly remotely in the states 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 enhance engagement to support… more
- University of Utah Health (Murray, UT)
- …clinical, coding , and IT teams to ensure compliance, optimize risk adjustment revenue, and help drive provider engagement interventions. **Qualifications** ... trust that are integral to our mission. EO/AA_ + Risk Adjustment Analyst position provides support for...(eg, SAS, Python, R, Excel). + Familiarity with ICD-10-CM coding , HCC mappings, and risk score calculations.… more
- Commonwealth Care Alliance (Boston, MA)
- …data, including claims, encounters, diagnoses, and provider data. + Familiarity with CMS risk adjustment methodologies and HCC coding preferred. + Experience ... Director of Encounter Data Management within the Revenue Cycle Department, the Risk Adjustment Data Developer is responsible for the design, development, and… more
- Henry Ford Health System (Detroit, MI)
- …to maximize accurate reimbursement. + Support initiatives for quality reporting, risk adjustment , provider education, and regulatory compliance. Innovation, ... and ensuring the financial strength of our system. As the Director of Procedural and Anesthesia Coding , you'll set the strategy and lead system-wide efforts to… more
- St. Mary's Healthcare (Amsterdam, NY)
- …Demonstrated knowledge of ICD-10-CM/PCS, CPT/HCPCS coding , MS-DRGs, APR-DRGs, APCs, and risk adjustment . Certifications / Licensure: + RHIA, RHIT, or CCS ... factors permitted by law. Responsibilities: + Provide day-to-day leadership to coding teams across inpatient, outpatient and professional services. + Partner with… more
- Penn Medicine (Bala Cynwyd, PA)
- …of relevant coding medical professional services experience including ambulatory outpatient and risk adjustment coding . (Required) + Certified Risk ... Hospice- 150 Monument Road** **Hours: Full-Time** **Job Summary:** The Ambulatory Coding and Documentation Specialist reports to the Primary Care Service Line,… more
- HCA Healthcare (Dallas, TX)
- … coding and documentation improvement education to Providers. + Assists the Director Coding Operations Division Support in reviewing progress against business ... Coder (CPC(R)) credential or Certified Professional Coder - Hospital (CPC-H(R)) or Certified Risk Adjustment Coder (CRC) EXPERIENCE: + Experience with Cerner and… more
- HCA Healthcare (Richmond, VA)
- … coding and documentation improvement education to Providers. + Assists the Director Coding Operations Division Support in reviewing progress against business ... (CPC(R)) credential or Certified Professional Coder - Hospital (CPC-H(R)) or Certified Risk Adjustment Coder (CRC) **EXPERIENCE:** + Experience with Cerner and… more
- Scripps Health (San Diego, CA)
- …Categories (HCCs) for accuracy and compliance as relates to Outpatient CDI. Monitors Risk Adjustment Factor (RAF) Scores. * Directs instructions and education ... This Senior Director position is eligible to participate in the...you will have primary accountability for the oversight of Coding , Clinical Documentation Integrity (CDI) and Health Information Management… more
- Elevance Health (Grand Prairie, TX)
- …Capabilities and Experiences:** + Deep understanding of CMS-HCC and/or HHS-HCC risk adjustment methodologies strongly preferred. + Experience partnering with ... **Clinical Compliance Medical Director ** _Please note that per our policy t_...regulatory, compliance, and legal matters strongly preferred. + Certified Risk Adjustment Coder (CRC) or similar credential… more
- Amazon (Mountain View, CA)
- …with business teams on science-heavy problems, incubating products with high AI research risk , reducing friction and manual effort with AI tooling, and raising the ... Mathematics). - Experience in industry, consulting, government, or academic research. - Coding ability in a scripting language such as R, Python, Matlab, or… more
- University of Michigan (Ann Arbor, MI)
- …Liaisons (RQL). Understand and articulate data and analysis clinical documentation and risk adjustment coding trends. **Mission Statement** Michigan Medicine ... Documentation Specialist (CDS) is responsible for applying their knowledge of medical terminology, risk adjustment , and coding to ensure appropriate capture… more
- Apex Health Solutions (Houston, TX)
- …Supervisor: Director , VBC Operations Required License(s)/ Certification(s): Certified Risk Adjustment Coder (CRC), Certified Professional Coder (CPC), or ... inpatient and/or outpatient medical records to ensure proper ICD-10 coding and compliance with risk adjustment...ensure proper ICD-10 coding and compliance with risk adjustment requirements. Essential Duties and Responsibilities… more
- Hartford HealthCare (Farmington, CT)
- …observed to expected ratio (O:E), capture of appropriate severity of illness (SOI) and risk of mortality (ROM), risk adjustment and hierarchal condition ... work in collaboration with the clinical documentation specialists (CDS), coding professionals, providers, nursing staff and other patient care...capture (HCC) codes, risk adjustment , and other high quality documentation outcome measures. .… more
- AdventHealth (Maitland, FL)
- …in understanding professional and facility claims and managed care concepts such as risk adjustment , capitation, FFS, DRG, APG, APCs and other payment mechanisms ... methodology, data tools, modeling, managing revenue, and managing and mentoring of director reports. Must be able to complete extensive and complex financial,… more