- CVS Health (Hartford, CT)
- … Programs for a portfolio of Aetna Better Health Medicaid Plans. Reporting to the Senior Manager of Medicaid Risk Adjustment , the Market Manager of ... submission and quality assurance) across revenue integrity processes related to risk adjustment (RA) focused on complete and accurate diagnosis capture and… more
- CVS Health (Dover, DE)
- …more personal, convenient and affordable. Position SummaryThe Revenue Integrity (RI) Sr. Manager , Business Consultant ( Risk Adjustment ) is responsible for ... management and monitoring of designated market/territory specific to the performance of risk adjustment (RA). The role is responsible for all aspects of driving… more
- CVS Health (Jackson, MS)
- …solutions to make health care more personal, convenient and affordable. As the Senior Manager , Risk Adjustment (Medicare) will be responsible for leading ... Risk Adjustment for the Georgia & the Gulf States Medicare...This role will have responsibility in maintaining and improving risk adjustment accuracy by partnering closely with… more
- CVS Health (Atlanta, GA)
- …solutions to make health care more personal, convenient and affordable. As the Senior Manager , Risk Adjustment (Medicare) will be responsible for leading ... Risk Adjustment for the Georgia & the Gulf States Medicare...have specific responsibility for Georgia in maintaining and improving risk adjustment accuracy by partnering closely with… more
- Corewell Health (Grand Rapids, MI)
- Job Summary As a key leader in the Risk Adjustment team, the successful candidate will develop and execute strategies, programs and projects for both the MA and ... clients/providers. The position also serves as a subject matter expert for the Risk Adjustment team. Essential Functions + Manages the daily workflow of Risk … more
- Highmark Health (Columbus, OH)
- …- Medicare Advantage, Medicaid, Affordable Care Act + Demonstrated knowledge of risk adjustment principals + Health Insurance and/or managed care industry ... time and budget and under circumstances involving multiple moderate-probability, moderate-impact risk factors. Manages a matrix group of employees and contractors… more
- CVS Health (Northbrook, IL)
- …Reporting to the Provider Engagement Lead Director of Medicaid Risk Adjustment Provider Engagement , the Manager will work closely with cross-functional ... opportunity for an enthusiastic team player to lead local market Medicaid Provider Engagement risk adjustment initiatives across the Aetna Better Health Plans.… more
- CVS Health (Hartford, CT)
- …management, health and economic outcomes, and other business needs. Reporting to the Sr. Manager of Medicaid Risk Adjustment Analytics, the Sr. Analyst will ... care more personal, convenient and affordable. Position Summary The Medicaid Risk Adjustment Sr. Analyst will play a critical role in extracting, analyzing,… more
- The Cigna Group (Mclean, VA)
- … Risk Adjustment goals. The role will work under the direction of Risk Adjustment Manager to reach overall operational market goals in conjunction ... to meet established goals. **Core Responsibilities:** + In partnership with Risk Adjustment Manager , support the training and development of Senior… more
- CVS Health (Hartford, CT)
- …responsible for provider/vendor/network outreach, production management, and reporting for the Risk Adjustment Retrospective Program for ACA, Medicare, MMP and ... DSNP lines of business. Required Qualifications 5+ years of finance related experience generally required, healthcare finance a plus. Excellent communication skills and negotiations skills Advanced Microsoft Excel, SAS skills desired Advanced skills in turning… more
- LA Care Health Plan (Los Angeles, CA)
- Enterprise Risk Adjustment Analyst III Job Category: Accounting/Finance Department: Risk Adjustment Strategies & Initiatives Location: Los Angeles, CA, ... and to support the safety net required to achieve that purpose. Job Summary The Enterprise Risk Adjustment Analyst III will provide a key leadership role in the … more
- Point32Health (Canton, MA)
- …this individual will be responsible for supporting critical data submission functions for the Risk Adjustment Department (RAD) including risk adjustment ... and timely resolution of production issues pertaining to CMS and risk adjustment data submission, including issue investigation, business requirements,… more
- ChenMed (Miami, FL)
- …We're rapidly expanding and we need great people to join our team. The Risk Adjustment Coder works in a collaborative effort directly with physicians and ... to review medical records and other clinical documentation to identify appropriate risk adjustment codes and quality gap closure opportunities. A major… more
- HSBC (New York, NY)
- …all relevant risk areas eg credit risk , counterparty credit risk , securitization, and Credit Valuation Adjustment ('CVA'). GRPA currently maintains a ... establishment of interpretations and governance processes to mitigate regulatory risk . GRPA also monitors new rule developments and other...City area may be considered. As our Regulatory Policy Manager - Credit Valuation Adjustment you will:… more
- ChenMed (Miami, FL)
- …Disease Detection (HRDD) Manager will be responsible for supporting the company Risk Adjustment program and ensuring that risk exposures and ... non-clinician office staff on coding guidelines, documentation standards, and appropriate Medicare Risk Adjustment (MRA) procedures. + Assists in education and… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- Property Claims Manager (State Risk Adjuster 6) Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4476650) Apply Property Claims Manager ... Work: Manager . Supervision Received: Administrative direction from the State Risk Administrator (Claims). Supervision Exercised: Direct line over State Risk … more
- PNC (Pittsburgh, PA)
- …in a location within PNC's footprint. We are seeking an accomplished Senior Validation Manager to lead our Market Risk Model and Counterparty Credit Risk ... Senior you will be a member of the Independent Risk Management team reporting to PNC's Chief Model ...Credit Valuation Adjustment (CVA), and Funding Valuation Adjustment (FVA). The Senior Validation Manager will… more
- Bloomberg (New York, NY)
- Portfolio and Risk Analytics Solutions (PORT) Account Manager , Enterprise Sales - Bloomberg Financial Solutions **New York, NY** Posted Apr 2, 2024 - Requisition ... PORT Enterprise Sales team members sell state-of-the-art enterprise level Portfolio and Risk Analytics Solutions to the world's top institutional buyside firms. PORT… more
- Trinity Health (Albany, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **TITLE** Risk Manager **DEPARTMENT:** Clinical Quality & Safety **REPORTS TO:** Regional ... to who we say we are. **POSITION SUMMARY** The Risk Manager is responsible for the implementation...+ Participates in evaluation of claims for settlement /or risk adjustment within ministry authority. Advises billing… more
- Inspire Brands (Atlanta, GA)
- …embarked on an exciting journey at Inspire Brands to reimagine our Enterprise Risk and Internal Audit functions to align with Inspire's strategic objectives. The ... Manager , Internal Audit - Technology will have the exciting...Audit - Technology who reports to the VP, Enterprise Risk and Chief Audit Executive (CAE). In this highly… more