- Henry Ford Health System (Troy, MI)
- The Director of Risk Adjustment & Value Based Payment is an unparalleled opportunity with Henry Ford Health. This pivotal role spearheads strategic endeavors ... value-based care. Join us in revolutionizing healthcare delivery! The Director of Risk Adjustment and...limited to HAP, physician leadership, administration, operations, finance, IT, managed care, and human resources to meet project goals.… more
- Martin's Point Health Care (Portland, ME)
- …been certified as a "Great Place to Work" since 2015. Position Summary The Senior Director of Risk Adjustment Operations in our Health Plan is responsible ... maintenance, monitoring and oversight of Medicare Risk Adjustment initiatives and operations. The Senior Director ...Degree + 10 years of experience in health care, managed care, health insurance or strategic consulting + and… more
- Centene Corporation (Raleigh, NC)
- …medical record audits, analysis of practice coding patterns, education and training regarding risk adjustment to ensure accurate CMS payment and improve quality ... and market level. + Subject matter experts for proper risk adjustment coding and CMS data validation....include Provider Relations, Quality as well as the Medical Director for the state assigned to ensure compliance of… more
- International Rescue Committee (Baltimore, MD)
- Requisition ID: req51568 Job Title: Legal Services Director Sector: Legal Employment Category: Regular Employment Type: Full-Time Compensation: USD 110,000.00 - ... Arrangement:In-person Job Description JOB OVERVIEW: IRC seeks a Legal Services Director to provide vision, strategy, and leadership to immigration legal services… more
- Zions Bancorporation (El Segundo, CA)
- …risk team independent of the business' front-line revenue-generating units. The Market Risk Analytics - Director will be responsible for enhancing the ... Adjustment (CVA). As part of the independent market risk control function, this individual would also be responsible...these analytics, if required. To be successful, the Market Risk Analytics - Director will partner with… more
- CVS Health (Columbus, OH)
- …treatment protocols for DSNP/MMP and other complex health populations to optimize risk adjustment , clinical quality, and care management* Actively participate in ... of clinical initiatives and programs to address the needs of the populations managed to improve health outcomes* Leverage extensive knowledge of health care delivery… more
- Molina Healthcare (Detroit, MI)
- …regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, Medicaid,… more
- Molina Healthcare (Albuquerque, NM)
- …regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... **REQUIRED EXPERIENCE:** * 5 years previous experience as a Medical Director in clinical practice * 3 years' experience in Utilization/Quality Program… more
- Actalent (Bridgewater, NJ)
- **IMMEDIATE NEED FOR PERMANENT DIRECTOR OF CLINICAL OPERATIONS OPPORTUNITY WITH AN ESTABLISHED ONCOLOGY PHARMA** **RECENT ONCOLOGY PHASE III EXPERIENCE NEEDED** ... according to the agreed project plan. Complete a study risk assessment and ensure mitigation and contingency measures are...unwarranted change orders) and budget, so both can be managed appropriately. + People and Resource Management + Responsible… more
- VIP Care (Tampa, FL)
- …Medical Record (EMR) system to review Patient records + Proficiency in Medicare Risk Adjustment + Effective communication and interpersonal skills + Proficiency ... Summary/Objective: The Senior Medical Director is responsible for leading efforts to develop...of clinical experience + 3 or more years of managed care experience + Experience in Utilization Management and… more
- Actalent (Phoenix, AZ)
- HIRING A DIRECTOR OF CONSTRUCTION TO OVERSEE PROJECT MANAGEMENT, FIELD OPERATIONS AND SAFETY! PAY $170,000-$200,000 DEPENDING ON EXPERIENCE Description: Our client ... has an immediate need to hire a Director of Construction to support their Phoenix operation and...balancing customer experience with protecting the company against unnecessary risk and loss. + Perform other duties as required… more
- Bristol Myers Squibb (Devens, MA)
- …lives. Read more: careers.bms.com/working-with-us . Position Summary: The Associate Director Supplier Relationship Manager (SRM) is accountable for overall ... network partners are identified at the right time and managed to assure robust supply of BMS cell and...CMOs with focus on creating the agility, flexibility, and risk -sharing frameworks to support the fluidity associated with novel… more
- Actalent (Phoenix, AZ)
- Main Responsibilities: As the Director of Construction, you play a pivotal role within the Leadership Team, overseeing project management, field operations, and ... balancing customer experience with protecting the company against unnecessary risk and loss. Perform other duties as required to...years of experience in construction operations and management Has managed and supervised a team for at least five… more
- CareOregon (Portland, OR)
- …Advantage bid; advise internal leadership on potential bid pricing strategies. + Collaborate with Risk Adjustment team to monitor risk adjustment applied ... processes + Knowledge of Medicare Advantage bid process + Understanding of various risk adjustment methodologies (eg CDPS+Rx, CMS-HCC, ACG, ERG, MARA) + Strong… more
- AdventHealth (Shawnee, KS)
- …coordinates and facilitates the development of a discharge plan of care for high- risk patient populations. This role will receive referrals for individuals from at- ... risk populations from interdisciplinary team members (including physicians, RN...substance use and addictive disorders + Provides patient/family education, adjustment -to-illness counseling, grief counseling and crisis intervention + Provides… more
- AdventHealth (Hinsdale, IL)
- …coordinates and facilitates the development of a discharge plan of care for high- risk patient populations. This role will receive referrals for individuals from at- ... risk populations from interdisciplinary team members (including physicians, RN Care Managers, staff nurses, and other members of the care team). The Social Work Care… more
- Loretto Management Corporation (Syracuse, NY)
- …assists in analysis as appropriate. Acts as back up person for completion of risk adjustment reports. + Monitors compliance with procedures relevant to clinical ... the general direction and supervision of the Health Information Director /Designee, the Compliance Reimbursement Specialist is responsible for analyzing documented… more
- Baptist Memorial (Memphis, TN)
- …integrity of upstream, midstream and downstream revenue cycle activities that impact the adjustment processing of claims. + Conducts risk assessments to define ... claims. This role requires thorough understanding of regulatory requirements, managed care contract terms, facility-specific internal guidelines, revenue integrity,… more
- CareOregon (Portland, OR)
- …of Actuaries + Experience with Medicaid and Medicare + Experience estimating IBNR, risk adjustment transfers, and other health care liabilities and assets + ... Manager - Corporate Exemption Status Exempt Department Finance Manager Title Director , Actuarial Services Direct Reports Actuarial Staff Requisition # 24101 Pay… more
- San Jose State University (San Jose, CA)
- …+ Ability to conduct in-depth analysis and review of complex project schedules to guide adjustment as needed to manage schedule and risk + Possession of a ... Full Time Position Description Job Summary Under the oversight of the Senior Director , Design & Construction, the Senior Construction Manager is responsible for all… more