- Trinity Health (Fort Lauderdale, FL)
- …Medicare programs and regulations including fraud and abuse and Medicare Hierarchical Condition Coding Risk Adjustment + Excellent analysis and presentation ... experience in a leadership role in a capacity developing and implementing risk adjustment , coding , wellness assessment, and analytics programs and processes… more
- Henry Ford Health System (Troy, MI)
- …adjustment . + Working with appropriate system and revenue cycle leadership, ensures risk adjustment coding representation and participation in appropriate ... The Director of Risk Adjustment ...The Director of Risk Adjustment & Value Based Payment...benchmarks. + Serves as an internal consultant on HCC coding , risk adjustment , and value-based… 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 ... coding policies for the organization. The Senior Director is expected to lead the risk … more
- Somatus (Mclean, VA)
- Overview The Director , Medicare Risk Adjustment (MRA) will lead the execution strategy and implementation of the organization's Risk Adjustment ... + Partner with Finance and Analytics team to establish risk adjustment analytics such as predictive modeling for coding improvement opportunities, provider… more
- CareOregon (Portland, OR)
- … Adjustment Analytics Manager Exemption Status Exempt Department Finance Manager Title Director , Risk Adjustment Direct Reports Risk Adjustment ... Responsibilities Technical and Operational Management + Work with the Director of Risk Adjustment in... regulations and requirements + Knowledge of medical claim coding and Medicare Advantage payment methodology Skills and Abilities… more
- Centene Corporation (Raleigh, NC)
- …of interventions at the provider and market level. + Subject matter experts for proper risk adjustment coding and CMS data validation. + Work in conjunction ... practice coding patterns, education and training regarding risk adjustment to ensure accurate CMS payment...include Provider Relations, Quality as well as the Medical Director for the state assigned to ensure compliance of… more
- CVS Health (Northbrook, IL)
- …initiatives across the Aetna Better Health Plans. Reporting to the Provider Engagement Lead Director of Medicaid Risk Adjustment Provider Engagement , the ... healthcare experience required including some combination of: - Experience in risk adjustment , medical coding , and documentation - Experience in provider… more
- CVS Health (Jackson, MS)
- …The role drives, in collaboration with the national and local risk adjustment teams, risk coding improvement activities within the region, medical ... record collection, provider collaboration and data sharing, general coding education and related activities, as well as other...working with providers. This position reports to the Lead Director of Risk Adjustment for… more
- CVS Health (Atlanta, GA)
- …The role drives, in collaboration with the national and local risk adjustment teams, risk coding improvement activities within the region, medical ... record collection, provider collaboration and data sharing, general coding education and related activities, as well as other...working with providers. This position reports to the Lead Director of Risk Adjustment for… more
- HCA Healthcare (Salt Lake City, UT)
- … 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
- Emanate Health (Covina, CA)
- …MSO personnel on HCC and STAR measures related tasks. Responsible to ensure the IPA risk adjustment factor maintains or exceeds 1.0 and achieves or improves upon ... Responsible for the oversight of HCC Program and STAR measures coding related functions. The HCC coding specialist will work with the IPA Director , Health… 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 ... open to change, go ahead and unlock your potential. Join Scripps asSenior Director , Revenue Cycle where you will have primary accountability for the oversight of… more
- Walmart (Bentonville, AR)
- …for the development and delivery of provider education and training as assigned, including risk adjustment , quality, focus on care, and optimal care. + Develops ... Prior working experience in educational training content, Sharepoint, or LMS systems., Risk adjustment or quality. **Primary Location ** 2608 Se J… more
- Mitsubishi Chemical Group (Jersey City, NJ)
- …on real-world evidence, and creating hope for all facing illness. The Director , Government Accounts will be responsible for the development and implementation of ... insure coordinated/targeted pull through with the field Sales and Marketing. The Director , Government Accounts will maintain a high level of collaboration and… more
- reveleer (CA)
- …plans across all business lines greater control over their Quality Improvement, Risk Adjustment , and Member Management programs. With one transformative ... Senior Director , Engineering Operations Location: Glendale, CA or Remote...every aspect of enrollment, provider outreach and data retrieval, coding , abstraction, reporting, and submissions. Leveraging proprietary technology, robust… 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...delivery of healthcare including, but not limited to clinical coding (ICD-10, CPT, and DRG), medical record review, population… 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 ... chart review related to such claims and provides feedback to the Health Information Director . + Keeps current on Correct Coding Initiative Edits and works with… more
- Highmark Health (Dover, DE)
- …in a Healthcare-related field **Substitutions** + 6 years of combined experience with RN/LPN, Risk Adjustment HCC Coding , medical coding /billing, HEDIS, ... + None **EXPERIENCE** **Required** + 5-10 years of combined experience with RN/LPN, Risk Adjustment HCC Coding , medical coding /billing, HEDIS,… 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 ... DRG Auditor works under the direction of the Associate Director of CDI Quality and Education. He/she performs all...Audits will be conducted retrospective (post-discharge, pre-bill) once final coding has been completed. The Lead CDI DRG Auditor… more
- Vatica Health (Seattle, WA)
- …, healthcare billing, quality and Value Based Care measures and metrics. Risk Adjustment knowledge/experience is preferred. + Understanding of Medicare, ACD, ... Manager of Clinical Operations collaborates with and reports to the Senior Director of Clinical Operations on clinical and non-clinical issues (employee relations,… more