- Highmark Health (Columbus, OH)
- …- Medicare Advantage, Medicaid, Affordable Care Act + Demonstrated knowledge of risk adjustment principals + Health Insurance and/or managed care industry ... might jeopardize successful achievement of the desired results of a program , develop risk mitigation strategies and tactics, and implement risk mitigation… more
- CVS Health (Hartford, CT)
- …is responsible for provider/vendor/network outreach, production management, and reporting for the Risk Adjustment Retrospective Program for ACA, Medicare, ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. In addition to your… more
- CareOregon (Portland, OR)
- Job Title Risk Adjustment Analytics Manager Exemption Status Exempt Department Finance Manager Title Director, Risk Adjustment Direct Reports ... Responsible for the development, execution, and management of the risk adjustment data analytics programs for the...analyses and reporting to engage key stakeholders and communicate program results to the organization. + Analyze RAF build… 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)
- … Programs for a portfolio of Aetna Better Health Medicaid Plans. Reporting to the Senior Manager of Medicaid Risk Adjustment , the Market Manager of ... and quality assurance) across revenue integrity processes related to risk adjustment (RA) focused on complete and...program or programs that is jointly accountable for risk adjustment strategy, performance, and results within… more
- Corewell Health (Grand Rapids, MI)
- …reporting metrics, including scorecards for both internal and external stakeholders. + Communicate Risk Adjustment program to internal & external audiences ... experts routinely to design and develop core educational materials for the prospective risk adjustment program . + Services will include but are not limited… 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...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… 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...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… more
- The Cigna Group (Mclean, VA)
- …to base salary._** This role is responsible for supporting Cigna Medicare Advantage's Risk Adjustment program for assigned populations in an operational ... goals. The role will work under the direction of Risk Adjustment Manager to reach...health plan coding initiatives guidelines and requirements of the Risk Adjustment program to ensure… more
- CVS Health (Dover, DE)
- …more personal, convenient and affordable. Position SummaryThe Revenue Integrity (RI) Sr. Manager , Business Consultant ( Risk Adjustment ) is responsible for ... the management and monitoring of designated market/territory specific to the performance of risk adjustment (RA). The role is responsible for all aspects of… 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)
- …ad hoc analyses specific to risk score trends, data/claims submissions and program performance to support risk adjustment analytics + Perform data ... this individual will be responsible for supporting critical data submission functions for the Risk Adjustment Department (RAD) including risk adjustment … 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 ... more personal, convenient and affordable. Position Summary The Medicaid Risk Adjustment Sr. Analyst will play a...for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed… 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)
- …Risk 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)
- …(Underwriting and Loss Prevention) by the absence of responsibility for the comprehensive risk program . Differs from the State Risk Administrator (Claims) ... Property Claims Manager (State Risk Adjuster 6) Print...Claims & Disaster and Recovery Management Unit is a program manager position within ORM, and provides… 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
- Inspire Brands (Atlanta, GA)
- …Company + Implement and maintain a best in class and modernized technology audit program + Contribute to the technology risk perspective in the development of ... 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 … more
- Inspire Brands (Atlanta, GA)
- … and Internal Audit functions to align with Inspire's strategic objectives. The Manager , Enterprise Risk and Internal Audit, will have the exciting opportunity ... This role will report directly to the Director, Enterprise Risk & Internal Audit - Finance, who reports to...and maintain a best in class and modernized audit program + Contribute to the financial and business process… more
- Amentum (Washington, DC)
- …seeking a subject matter Experts (SME) to provide instruction at a Case Manager / Risk and Needs Assessment in Prisons to perform assessments, provide ongoing ... the Criminal Division's International Criminal Investigative Training and Assistance Program (ICITAP). https://www.justice.gov/criminal-icitap. ICITAP is a cornerstone of America's… more