- New York State Civil Service (New York, NY)
- NY HELP No Agency Financial Services, Department of Title Virtual Currency Financial Crime Risk Associate (FSS4 Fin Crime Risk ) Occupational Category Other ... Services is seeking candidates for the position of Virtual Currency Financial Crimes Risk Associate in the Virtual Currency Unit. Duties include, but are… more
- CareFirst (Baltimore, MD)
- …across Medicare & Medicaid populations. Responsible for developing performance monitoring reports and analytics related to Risk Adjustment & Stars programs ... **Resp & Qualifications** **PURPOSE:** Supports Risk Adjustment & Stars organization to...indirectly on Federal health care programs. **PHYSICAL DEMANDS:** The associate is primarily seated while performing the duties of… more
- Providence (NM)
- …Medicare Advantage plans + Have a deep understanding of Medicare Advantage regulations, risk adjustment methodologies, and a strong analytical background + Be ... the pricing process + Staying informed of changes in risk adjustment methodologies and assess their implications...study + Successful completion of 4+ exams of the Associate of the Society of Actuaries (ASA) designation +… more
- Johns Hopkins University (Baltimore, MD)
- …The JH-ACG's research and development team is an international leader in health care risk adjustment and advanced predictive analytics . JH-ACG solution is an ... fields of population health, health care delivery systems, health policy, and risk stratification/prediction. A special emphasis of this position is on the… more
- New York State Civil Service (Albany, NY)
- …No Agency Financial Services, Department of Title Virtual Currency Associate (Financial Services Specialist 4(VC), SG-27 Occupational Category Financial, Accounting, ... Law, Mathematics, Public Administration, Public Affairs, Public Health, Public Policy, or Risk Management and five (5) years of specialized experience in one (1)… more
- Commonwealth Care Alliance (Boston, MA)
- …+ Maintain current industry knowledge of highly impactful external audits such as Risk Adjustment Data Validation Audit, CMS Program Audit protocols, common ... + Contribute towards the maintenance and enhancement of an effective Compliance Risk Assessment Program + Project manage regulator and other external reviews as… more
- Humana (Columbus, OH)
- …advancing the care experience of our members and provider partners through integrated risk adjustment (RA) and quality (Stars) solutions that leverage data and ... technology to empower members, providers, and Humana. The Risk Adjustment Prospective Provider Programs organization within HQRI delivers a portfolio of products… more
- Emory Healthcare/Emory University (Atlanta, GA)
- …areas of documentation improvement such as DRG accuracy, compliance, severity of illness, risk of mortality and risk adjustment factors during inpatient ... Documentation Integrity (CDI) DRG Auditor works under the direction of the Associate Director of CDI Quality and Education. He/she performs all the requirements… more
- Veterans Affairs, Veterans Health Administration (Durham, NC)
- …and is supervised by the HPE Manager with oversight provided by the Associate Chief of Staff/Education, Designated Education Officer (DEO), who reports to the Chief ... General (OIG), Government Accountability Office (GAO), and VHA Enterprise Risk Register. Assesses Veterans Equitable Resource Allocation Education Support Supplement… more
- Providence (NM)
- …the rate development and filing efforts including competitive analysis, network analysis, risk adjustment , trend, actuarial benefit value analysis, rate adequacy ... another related field of study + Successful completion of 4+ exams of the Associate of the Society of Actuaries (ASA) designation + 5+ years of healthcare actuarial… more
- Humana (Columbus, OH)
- …market-based processes that support Provider Engagement, Quality/Stars, Interoperability, and Medicare Risk Adjustment (MRA) business levers. This role calls for ... existing operating model by leveraging performance and productivity data and front-line associate feedback + Optimize the operating model by identifying and scaling… more
- Walmart (Cheektowaga, NY)
- …training (for example, safety, control troubleshooting, oil system operation and adjustment ) by traveling to company facilities for on-site sessions; performing ... Demonstrates curiosity and a growth mindset; supports innovation and intelligent risk -taking; and exhibits resilience in the face of setbacks. Digital Transformation… more