- The Cigna Group (Bloomfield, CT)
- …+ Responsible for identifying and influencing adoption of resources and processes to reach risk adjustment and quality goals of assigned provider groups ... audit departments regarding compliance, coding, and inappropriate coding. + Attend risk adjustment and quality provider meetings for assigned provider groups… more
- CVS Health (Jackson, MS)
- …deliver solutions to make health care more personal, convenient and affordable. As the Senior Manager, Risk Adjustment (Medicare) will be responsible for ... 5+ years of experience with one or more of the following methodologies: risk adjustment , clinical quality , or healthcare quality improvement* Experience… more
- CVS Health (Atlanta, GA)
- …deliver solutions to make health care more personal, convenient and affordable. As the Senior Manager, Risk Adjustment (Medicare) will be responsible for ... 5+ years of experience with one or more of the following methodologies: risk adjustment , clinical quality , or healthcare quality improvement* Experience… more
- LA Care Health Plan (Los Angeles, CA)
- …recommendations to senior leadership based on analytics outcome. Knowledge of risk adjustment processes for multiple lines of business. Reporting and ... Enterprise Risk Adjustment Analyst III Job Category:...Mission: LA Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and… more
- Point32Health (Canton, MA)
- …strategic initiatives and improvement opportunities + Work collaboratively with risk adjustment provider educators and the quality assurance team to focus ... individual will support the operations and analysis of all risk adjustment programs and serve as the...ad hoc analyses to improve awareness and understanding of risk scores and the quality , accuracy and… more
- CVS Health (Hartford, CT)
- …Leadership and Innovation 20% + Recruit, develop and retain a high performing, high quality risk adjustment talent pool that is respected within Medicaid ... of Aetna Better Health Medicaid Plans. Reporting to the Senior Manager of Medicaid Risk Adjustment...quality assurance) across revenue integrity processes related to risk adjustment (RA) focused on complete and… more
- US Tech Solutions (Newark, NJ)
- …with all state regulations, federal regulations, internal policies, and internal procedures. HCC Risk Adjustment Coders will be involved with activities of code ... Summary: The Senior Professional Coder provides services to perform code...the following programs; including but not limited to, Commercial Risk Adjustment , Medicare Advantage Risk … more
- Healthfirst (NY)
- …+ Must have a bachelors degree from an accredited institution. + Experience with Risk Adjustment Methodologies (CMS-HCC, HHS-HCC, CDPS, 3M CRG) or Value based ... + Develop and track measures showing vendor effectiveness and quality results. Share these results with the vendor and...Tables, Advanced Formulas) + Able to present information to senior and executive leadership on the progress of activities… more
- CareFirst (Baltimore, MD)
- …stakeholders including Stars/ Quality , Finance and Actuarial areas to optimize Risk Adjustment performance, accurate coding and drive overall quality ... in addition to the required work experience. **Experience:** 5 years' experience in Risk Adjustment / Quality /Stars departments with a data visualization and… more
- Bloomberg (New York, NY)
- Senior Risk Data Analyst - First Line of...hard, and we work fast - while keeping up the quality and accuracy we're known for. It's what keeps us ... clients, and other external stakeholders continue to evolve. We are looking for a Senior Risk Analyst who will develop a deep understanding of our products… more
- The Cigna Group (Bloomfield, CT)
- …+ Responsible for identifying and influencing adoption of resources and processes to reach risk adjustment and quality goals of assigned provider groups ... audit departments regarding compliance, coding, and inappropriate coding. + Attend risk adjustment and quality provider meetings for assigned provider groups… more
- Highmark Health (Columbus, OH)
- …(such as quality and compliance), and/or physicians to identify and deliver high quality and accurate risk adjustment coding. Supports all risk ... and Medicaid Services (CMS) coding guidelines, and support of Risk Adjustment Data Validation (RADV) audits. Works...and thorough capture of members' chronic health conditions. Conducts quality reviews of high- risk and incremental HCCs… more
- Bloomberg (New York, NY)
- …advisory services to businesses and departments. In addition, we are responsible for risk reporting to firm-wide partners and senior management. In an ... Risk Manager - Core Product - Chief Risk ...hard, and we work fast - while keeping up the quality and accuracy we're known for. It's what keeps us… more
- Bloomberg (New York, NY)
- …advisory services to businesses and departments. In addition, we are responsible for risk reporting to firm-wide partners and senior management. In an ... Risk Officer - Enterprise Data - Chief Risk ...hard, and we work fast - while keeping up the quality and accuracy we're known for. It's what keeps us… more
- Bausch Health (Bridgewater, NJ)
- …Product reviews (APRs). Author and review the APRs, identify the trends and escalate critical quality issues to Senior Quality Management. + Lead and support ... our mission of improving people's lives with our health care products. The ** Senior Specialist, External Manufacturing Quality ** plays a crucial role in… more
- Bloomberg (New York, NY)
- …clients, and other external stakeholders continue to evolve. We are looking for a Senior Risk Analyst to join our team to be responsible for identifying, ... and we work fast - while keeping up the quality and accuracy we're known for. It's what keeps...and managing risks supporting the Core Product Organization. The Senior Risk Analyst will be responsible for… more
- Bristol Myers Squibb (Bothell, WA)
- …team and is responsible for implementation, management and monitoring of the sites Quality Risk Management (QRM) and Change Management program. This individual ... site. **Knowledge & Skills:** + Knowledge and experience with Quality Risk Management and Change Control. +...in their roles. Applicants can request a reasonable workplace accommodation/ adjustment prior to accepting a job offer. If you… more
- Highmark Health (Dover, DE)
- …Healthcare-related field **Substitutions** + 6 years of combined experience with RN/LPN, Risk Adjustment HCC Coding, medical coding/billing, HEDIS, and/or health ... and implements process improvements related to the potential of quality medical care and service to members and to...**Required** + 5-10 years of combined experience with RN/LPN, Risk Adjustment HCC Coding, medical coding/billing, HEDIS,… more
- Bloomberg (New York, NY)
- Risk & Valuations Sales Specialist (BVAL), Specialist Sales - Bloomberg Financial Solutions **New York, NY** Posted Mar 15, 2024 - Requisition No. 123852 Bloomberg ... work with the same information, the entire enterprise benefits. Bloomberg's Enterprise Risk & Valuation services deliver that consistency! From our high- quality … more
- CVS Health (Topeka, KS)
- …+ Knowledge of HEDIS and Pay for Performance metrics, ICD-10 coding, Medicaid risk adjustment methodology, and common billing and common billing practices + ... VA + San Antonio, TX + Southern, IL Position Summary This Senior Analyst, Healthcare Quality Management will be a Quality Practice Liaison who builds… more