- Humana (Annapolis, MD)
- …+ Oversight and support of all Market MRA functions + Policies, procedures, training, and education for all risk adjustment functions Ensures integration of ... Reporting and Improvement (HQRI) organization as Senior Vice President (SVP), Risk Adjustment Operations and Interoperability. This key leadership position… more
- Highmark Health (Annapolis, MD)
- …- 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
- CareFirst (Baltimore, MD)
- …IT and Data Services teams. Represents the Stars/ Risk Adjustment team during enterprise prioritization sessions. **QUALIFICATIONS:** ** Education Level:** ... **Resp & Qualifications** **PURPOSE:** Supports Risk Adjustment & Stars organization to...service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external… more
- The Cigna Group (Baltimore, MD)
- …populations in an operational market. The role will be accountable for assigned provider groups reaching risk adjustment related annual metrics. This ... assigned market. Lead Analyst will be primary contact for provider groups on Risk Adjustment ... office diagnosis coding. Implement provider office education , where necessary, and provide formal training… more
- Highmark Health (Annapolis, MD)
- … Risk Adjustment coding including documentation improvement, provider education , analyzing reports, and identifying process improvements. **ESSENTIAL ... anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation (RADV) Audits. Works closely with… more
- University of Maryland, Baltimore (Baltimore, MD)
- …options (if applicable per job). *Primary Duties - Social Worker:* * Assess risk by screening and interviewing clients. Identify and construct service plans that ... health, poverty, unemployment, substance abuse, physical abuse, rehabilitation, social adjustment , child care, and/or medical care in accordance with licensure.… more
- RELX INC (Annapolis, MD)
- About the Business LexisNexis Risk Solutions is the essential partner in the assessment of risk . Within our Government vertical, our solutions assist government ... informed decisions to enhance investigations. You can learn more about LexisNexis Risk at the link below. https:// risk .lexisnexis.com/government About our Team… more
- University of Maryland, Baltimore (Baltimore, MD)
- …partnerships between grassroots, non-profits, city agencies, and institutes of higher education by engaging in service provision, education , and research. ... evaluation, and advocacy to maximize the individual's well-being. * Assess risk by screening and interviewing clients. Identify and construct service plans… more
- Zurich NA (Annapolis, MD)
- …and financial perspective. We work with our wellbeing partners and industry experts to provide the best advice and access to a wealth of lifestyle support. We're ... minimal travel to industry events/conferences. Working with an award-winning Risk Management team as part of a Global insurer...the opportunity to let us know of any reasonable adjustment or practical support needed when you apply. **Required… more
- Humana (Annapolis, MD)
- …something similar **Preferred Qualifications** + Knowledge and/or experience within the Stars Organization, Risk Adjustment and/or Provider . + PMP or CAPM ... Intake, Charter, RACI Model/Roles and Responsibilities, Governance Structure, Project Plan, Risk /Issues Tracking, etc. + Analyze project portfolio to ensure project… more
- WelbeHealth (Annapolis, MD)
- …and post-visit chart reviews + Oversee audits and participate in provider education programs to ensure compliance with CMS risk adjustments diagnosis coding ... with Coding Supervisor in identifying opportunities for HCC coding education **Job Requirements:** + Associates Degree preferred; three (3)...and auditing + Minimum of two (2) years of Risk Adjustment (HCC) coding experience in a… more
- RELX INC (Annapolis, MD)
- …to measure and improve client satisfaction of our products. You will provide excellent customer support and value-added services to ensure retention and renewal ... with minimal supervision to develop strategies focused on customer retention, risk mitigation strategies, and renewal maintenance. + Identifying key contacts and… more
- Prime Therapeutics (Annapolis, MD)
- …for overseeing the development of recommended pricing terms; offer structure and risk analysis for highly complex and visible cases, primarily in the Health ... remain on a profitable basis and if needed, leverages contractual or internal adjustment remedies** **In partnership with Sales and Client Engagement, provide … more
- Travelers Insurance Company (Hunt Valley, MD)
- …including the scope, complexity and location of the role; the skills, education , training, credentials and experience of the candidate; and other conditions of ... their own inventory of complex claims, building knowledge of those matters. Provide guidance and expertise in forging effective relationships. Provide … more
- Aerotek (Hanover, MD)
- …financial and performance reporting, compensation, and Ad hoc analysis. Mitigates company risk through collaboration with sales teams and field partners to ensure ... per the 1/24 rule [respond within one (1) hour, provide resolution within twenty four (24) hours]. + Primary...functional level all policies and guidelines. + Mitigates company risk through collaboration with sales teams and field partners… more
- University of Maryland, Baltimore (Baltimore, MD)
- …at University of Maryland, Baltimore. The CCAND functions to evaluate and provide comprehensive care to adult individuals with autism, intellectual disability, and ... evaluation, and advocacy to maximize the individual's well-being. * Assess risk by screening and interviewing clients. Identify and construct service plans… more
- Mitsubishi Chemical Group (Annapolis, MD)
- …functions that arise in transactional work, including contract lifecycle management. + Provide guidance to increase the efficiency and scalability of legal support. ... Identify compliance issues, provide guidance, and consultation, and conduct periodic employee training...and acquisitions. **\#LI-BT1** \#LI-REMOTE Knowledge / Skills / Experience Education and Experience Requirements: + Bachelor's degree or a… more
- Mitsubishi Chemical Group (Annapolis, MD)
- …in the chemical manufacturing environment. + Conduct security assessments and risk analyses to identify vulnerabilities in OT systems and recommend mitigation ... meet our cybersecurity standards for OT systems. **Training and Awareness** + Provide cybersecurity awareness training focused on the unique risks and requirements… more