- Tufts Medicine (Burlington, MA)
- …coding meets both established coding standards as well as CMS and Commercial Risk Adjustment guidelines. This position has extensive knowledge of overall ... to improve overall provider documentation as it pertains to coding and risk adjustment guidelines. Reviews medical records to determine if diagnostic… more
- CVS Health (Dover, DE)
- …convenient and affordable. Position SummaryThe Revenue Integrity (RI) Sr. Manager, Business Consultant ( Risk Adjustment ) is responsible for the management ... necessary as deemed by the department leadership Required Qualifications + 3-5 years of Risk Adjustment experience Medicare , IFP, and/or Medicaid + Core… more
- Henry Ford Health System (Troy, MI)
- …monthly performance metrics and standards compared to benchmarks. + Serves as an internal consultant on HCC coding, risk adjustment , and value-based payment ... The Director of Risk Adjustment & Value Based Payment...successful in its participation in alternative payment models, including risk adjusted contracts, Medicare Shared Savings Program… more
- CareOregon (Portland, OR)
- …+ Knowledge of Medicare Advantage bid process + Understanding of various risk adjustment methodologies (eg CDPS+Rx, CMS-HCC, ACG, ERG, MARA) + Strong ... to impact rates. + Oversee and coordinate external actuarial consultant 's work preparing the annual Medicare Advantage...leadership on potential bid pricing strategies. + Collaborate with Risk Adjustment team to monitor risk… more
- CVS Health (Columbus, OH)
- …EMR platforms. Required Qualifications - CPC AAPC or CCA AHIMA certification- 3+ years risk adjustment experience in Medicare advantage or commercial- 3+ ... capture. Identifies opportunities to promote quality. Shares best practices in risk adjustment across all sites/regions. Simultaneously manages multiple, complex… more
- Intermountain Health (Las Vegas, NV)
- …leaders, physicians, advanced practice providers (APP), and other staff about documentation and risk adjustment in order to improve the accuracy of the overall ... mentor to leaders, physicians, APP's, and other staff about documentation and risk adjustment . + Reviews medical records documentation for reimbursement,… more
- Deloitte (Colorado Springs, CO)
- …experience with Medicaid waivers (ie, 1115, 1915 b/c, 1332) + 1 year +experience with risk adjustment mechanisms + 1 year + experience with health care reform ... Work you'll do As a Government Health Actuary - Consultant in Deloitte's Human Capital Actuarial and Insurance Solutions...small group markets + 1 year + experience with Medicare products, including Medicare Advantage or … more