- ManpowerGroup (Meridian, ID)
- …Needed?** + 3+ years' experience in the health industry, including medical record coding, preferably with HCC and/or Risk Adjustment coding experience. ... on-site methods. + Review, interpret, audit, code, and analyze medical records , claims, and encounter information as...Condition Categories (HCC). + Assist in the development of risk adjustment documentation, coding tools, and resources.… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …and procedures and business rule tools governing the response to Risk Adjustment Data Validation (RADV) Audits, prospective medical record coding, and ... we encourage you to apply! Job Description: Summary: The Risk Adjustment Coding Coordinator is responsible for...Records Departments and Business Office staff to coordinate medical record access and reviews in a… more
- Datavant (Concord, NH)
- …Knowledge of healthcare industry, payment models, risk adjustment , medical coding, physician workflow, and/or electronic health record systems + Advanced ... between internal resources and customers in support of custom risk adjustment projects and reports on project...work environment + Detail oriented, self‐starter with proven track record of execution and results + Team player with… more
- Blue KC (Kansas City, MO)
- … medical records to ensure proper coding and compliance with risk adjustment requirements + Monitorrisk adjustment vendors to ensure performance ... **Employee discount program** **Job Description Summary:** The Director, Government Programs Risk Adjustment & Audit assumes overall leadership of the… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …to help us transform healthcare? Bring your true colors to blue. The Medicare Risk Adjustment Strategy Program Manager will report to the Senior Director of ... Medicare Risk Adjustment and Analytics. This role will...strategies and tactics designed to ensure complete and accurate medical record documentation and coding. The Program… more
- Trinity Health (Syracuse, NY)
- …Ability to conduct Education if needed. Auditing Experience Posting POSITION PURPOSE: The Risk Adjustment Coding Specialist works in a team environment and is ... education and training will be conducted per Excellus payer risk adjustment coding guidelines and required of...Excel, Outlook and Teams. . Adept in Electronic Health Records and Professional Billing systems . High School Diploma… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …Bring your true colors to blue. Under the direction of the Senior Directory of Medicare Risk Adjustment and Analytics, the Director of Risk Adjustment ... the Medicare and Merged Market segments. The Director of Risk Adjustment Data and Analytics will oversee...identification of problems, and problem resolution + Proven track record of meeting timelines, deliverables, attention to detail and… more
- MedKoder (Mandeville, LA)
- …a flexible schedule. Description: MedKoder, LLC is seeking a remote Professional HCC Risk Adjustment Coder who will apply both technical and specialized ... government regulations while identifying opportunities for increased financial success. The HCC Risk Adjustment Coder provides coding services to health systems… more
- Commonwealth Care Alliance (Boston, MA)
- 011260 CCA-Revenue Cycle Management Position Summary: The Risk Adjustment Business Analyst is responsible for understanding and interpreting complex programs, ... methodology, and will play an essential role in driving Risk Adjustment (RA) Program performance. Supervision Exercised:...Understanding of medical terminology and familiarity with medical records . * Ability to interact and… more
- Highmark Health (Pittsburgh, PA)
- …Development and Management: + Provide strategic leadership and management for the Risk Adjustment Accuracy Management Department. + Develop and oversee programs ... adapt infrastructure (processes, systems, talent) to support an effective risk adjustment program as CMS/HHS/DPW evolves the...to monitor, audit and improve the quality of provider medical record documentation, and diagnosis coding. +… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …our Healthsource blog: https://healthsource.premera.com/ . **_About the role of Senior Risk Adjustment Operations Department Coordinator_** As the **Senior ... Risk Adjustment Operations Department Coordinator** , you will be providing...administrative and project support for data submissions, audits, and medical record retrieval. This is a critical… more
- Humana (Atlanta, GA)
- …3, position is a remote access role working with providers, vendors, projects and record retrieval associates. The Risk Adjustment Representative 3 + Role ... in calendar managemen **Preferred Qualifications** + Medical Record Retrieval knowledge + RADV experience Risk ... Record Retrieval knowledge + RADV experience Risk adjustment data validation + Strong written… more
- Datavant (Little Rock, AR)
- …healthcare actuarial or medical economics departments with a focus on risk adjustment valuation and modeling + Experience creating and communicating ... vision for healthcare. **What we're looking for:** The incoming Risk Adjustment Analytics Manager will be stepping...related to our core business functions + Successful track record leading and managing in a remote environment (2+… more
- UCLA Health (Los Angeles, CA)
- Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment , you will be an expert in risk adjustment coding and ... documentation, working closely with physicians, IPA coders, and risk adjustment teams associated with the health...associated with the health plan. You will: + Conduct medical record audits for physicians (MD, DO,… more
- Humana (Des Moines, IA)
- …The Risk Adjustment Representative 2 conducts quality assurance audits of medical records and ICD-9/10 diagnosis codes that are submitted to the Centers ... for Medicare and Medicaid Services (CMS) and other government agencies. The Risk Adjustment Representative 2 performs varied activities and moderately complex… more
- Mount Sinai Health System (New York, NY)
- …(2) close partnership with the CDQI Director to drive accurate risk adjustment throughout the system. This Medical Director must be effective at influencing ... improve the status quo **Role Summary:** MSHP seeks a Medical Director (MD), Physician Engagement and CDQI, who will...population health goals including access, quality, utilization and accurate risk adjustment with a group of practices… more
- Dignity Health (Bakersfield, CA)
- …analysis to demonstrate insights and trends related to patient engagement, Medicare risk adjustment , STARS/HEDIS, Medical management, and program ... service level agreements, among other areas. Essential Functions: 1. Proven track record of developing and managing an advanced analytics/insights data team. 2.… more
- Ventura County (Ventura, CA)
- Workers' Compensation Risk Analyst Print (https://www.governmentjobs.com/careers/ventura/jobs/newprint/4962949) Apply Workers' Compensation Risk Analyst Salary ... afforded a flexible credit allowance of up to $25,558 annually for purchasing medical , dental, and/or vision insurance from a group of authorized plans. + Flexible… more
- BP Americas, Inc. (Chicago, IL)
- …insightful reports and metrics showcasing operational effectiveness and alignment with desired risk tolerance levels. **Requirements** + Proven track record of ... pivotal role in shaping the global strategy of operational risk management within our organization. As a key member...to craft your career path, life and health insurance, medical care package and many others! We support our… more
- Bristol Myers Squibb (New Brunswick, NJ)
- …lives. Read more: careers.bms.com/working-with-us . **Position Summary** The Director, Quality Risk Management will drive consistent Global Leadership on Quality ... Risk Management (QRM), the Risk ...for key QRM processes within the GxPs (GMP, GDP, GLP, Medical Devices, Cell Therapy, GCP & GVP) across the Product… more