- Baystate Health (Springfield, MA)
- …care practice staff to schedule annual comprehensive visits. Assists with coordinating risk adjustment education and performance improvement projects. ... The Prospective Outpatient Risk Adjustment Coder supports risk...chronic conditions in the medical record, collecting data around provider documentation and coding practices, and identifying opportunities to… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …Key Responsibilities -Establish and maintain collaborative relationships with assigned providers / provider offices to improve risk adjustment coding and ... of documentation changes + 3 years Risk Adjustment Coding/Auditing and experience with direct provider ... Adjustment Coding/Auditing and experience with direct provider education + Health Insurance/ managed care… more
- Atrius Health (Newton, MA)
- …Team, participating in creating and implementing new initiatives for Atrius Health risk adjustment programs. EDUCATION /LICENSES/CERTIFICATIONS Graduate of a ... locations, more than 50 specialties and 825 physicians, we provide proactive, customized care to more than 720,000 adult...added. Acts as a mentor and role model to Risk Adjustment Specialist RNs assuring that they… more
- Atrius Health (Newton, MA)
- …Team, participating in creating and implementing new initiatives for Atrius Health risk adjustment programs. EDUCATION /LICENSES/CERTIFICATIONS Graduate of a ... welfare benefit package. **Job:** **Professional Non-Clinical* **Organization:** **Administration* **Title:** * Risk Adjustment Specialist* **Location:** *Newton MA -… more
- Centene Corporation (Columbia, SC)
- …an educational work plan for WellCare contracted providers. + Conduct provider education and training regarding risk adjustment to help to ensure ... knowledge of Medicare, Marketplace, and Medicaid risk adjustment is required. Provider education ...Medicaid risk adjustment is required. Provider education experience is preferred. **Licenses and… more
- Apex Health Solutions (Houston, TX)
- …and compliance with risk adjustment requirements. Reports to: AVP, STARs & Risk Adjustment Location: Houston, TX EDUCATION : * High School Diploma or ... SUMMARY: Risk Adjustment Coder is responsible for...of medical records requests for all risk adjustment projects. * Performs telephonic outreach to provider… more
- The Cigna Group (Houston, TX)
- …Stars gaps in care. The role will work under the direction of Risk Adjustment & Stars Provider Education Supervisor and/or Manager to reach overall ... operational market. The role will be accountable for assigned provider groups reaching risk adjustment ... office diagnosis coding. Implement provider office education , where necessary, and provide formal training… more
- Humana (Columbus, OH)
- …+ 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
- Centene Corporation (Indianapolis, IN)
- …sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment . Provides education for HEDIS measures, appropriate ... and NCQA requirements. + Collects, summarizes, trends, and delivers provider quality and risk adjustment ...encounters). + Identifies specific practice needs where Centene can provide support. + Develops, enhances and maintains provider… more
- The Cigna Group (UT)
- ** Risk Adjustment Provider Educator** **_Incumbent_** **_candidate must reside in assigned territory and have the ability to travel to the local office and ... operational market. The role will be accountable for assigned provider groups reaching risk adjustment ... office diagnosis coding. Implement provider office education , where necessary, and provide formal training… more
- Dignity Health (Bakersfield, CA)
- …Work with network providers to improve clinical documentation to better support CMS Risk Adjustment guidelines. - Develop education materials and tools ... and its clinical integrated networks throughout to identify opportunities for improved quality, risk adjustment coding performance. The Value Based Coder is a… more
- CVS Health (Northbrook, IL)
- …Better Health Plans. Reporting to the Provider Engagement Lead Director of Medicaid Risk Adjustment Provider Engagement , the Manager will work closely ... an enthusiastic team player to lead local market Medicaid Provider Engagement risk adjustment initiatives...administratively supported. + Lead the development and implementation of provider education strategies and action plans through… more
- CVS Health (Hartford, CT)
- …Knowledge of government-regulated healthcare programs such as Medicaid or Medicare - Risk Adjustment experience/knowledge Education Bachelor's Degree or ... a Senior Informatics Manager to join our dynamic Medicaid Risk Adjustment Analytics team! In this role...Adjustment Analytics team! In this role you will provide complex analytics and reporting to address business questions… more
- Tufts Medicine (Burlington, MA)
- … documentation. Summarizes findings for internal and external parties and will provide provider education when necessary. **Job Description** **Minimum ... lead efforts to evaluate the HCC/DxCG coding practices and provide analyses and recommendations to improve overall provider...provider documentation as it pertains to coding and risk adjustment guidelines. Reviews medical records to… more
- Somatus (Mclean, VA)
- …provider Network Management and the Quality Program to implement tactics for risk adjustment optimization, particularly for provider and member engagement ... Overview The Director, Medicare Risk Adjustment (MRA) will lead the...coding improvement opportunities, provider coding improvement opportunities, provider coding accuracy, risk score trending and… more
- CVS Health (Hartford, CT)
- …opportunity for an enthusiastic team player to lead a suite of market focused Risk Adjustment Programs for a portfolio of Aetna Better Health Medicaid Plans. ... Reporting to the Senior Manager of Medicaid Risk Adjustment , the Market Manager of...educational material as a result of claims data or provider requests. + Support local market colleagues in ensuring… more
- CVS Health (Atlanta, GA)
- …to make health care more personal, convenient and affordable. As the Senior Manager, Risk Adjustment (Medicare) will be responsible for leading Risk ... This role will have specific responsibility for Georgia in maintaining and improving risk adjustment accuracy by partnering closely with leadership from our key… more
- LA Care Health Plan (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 ... course of action. This position will work in collaboration with the Enterprise Risk Adjustment department leadership and provide leadership/guidance in… more
- CVS Health (Jackson, MS)
- …to make health care more personal, convenient and affordable. As the Senior Manager, Risk Adjustment (Medicare) will be responsible for leading Risk ... in Mississippi. This role will have responsibility in maintaining and improving risk adjustment accuracy by partnering closely with leadership from our… more
- Trinity Health (Syracuse, NY)
- …Services (CMS). **SKILLS, KNOWLEDGE, EDUCATION AND EXPERIENCE:** + Certified Risk Adjustment Coder (CRC) required or Certified Professional Coder (CPC) ... **Employment Type:** Full time **Shift:** **Description:** ** Risk Adjustment Coding Specialist - CNY...Adjustment Coding & Audit to develop and implement provider documentation improvement plans. Ensures medical documentation and coding… more