- Martin's Point Health Care (Portland, ME)
- …a "Great Place to Work" since 2015. Position Summary The Senior Director of Risk Adjustment Operations in our Health Plan is responsible the overall development, ... refinement, maintenance, monitoring and oversight of Medicare Risk Adjustment initiatives and operations. The Senior...for all aspects of the decision-making and implementation of medical record coding reviews and coding policies for the… more
- CVS Health (Dover, DE)
- …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 driving collaborative decision-making… 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 ... ('GRPA') is responsible for establishing HSBC's Group level, and certain regional level, prudential regulatory capital policies, and for advising business lines… more
- The Cigna Group (Westerville, OH)
- …work to leadership and key stakeholders. + Provide regular updates on market and regional level risk adjustment metrics and prospective program performance, ... This role is responsible for supporting Cigna Medicare Advantage risk adjustment prospective programs, solutions, and performance in aligned operational region… more
- Bristol Myers Squibb (San Francisco, CA)
- …RAD oversees their regional team to ensure disease and product related medical needs in the region are being identified. Oversight of the MSLs' primary ... program support (if applicable) + Contributes FM expertise to regional accounts aligned to Brand and Medical ...projects and priorities + Track record of effectively managing risk and compliance + Work in a matrix environment… more
- Carle (Urbana, IL)
- …AND KNOWLEDGE Possesses the "other knowledge and skills" of the Revenue Cycle Regional Representative 1. Knowledge of basic medical coding and third-party ... Rev Cycle Regional Rep 2 + Department: Revenue Cycle -...+ On Call Requirements: No + Work Location: Methodist Medical Center + Weekend Requirements: No + Holiday Requirements:… more
- HCA Healthcare (Salt Lake City, UT)
- …Coder (CPC(R)) credential or Certified Professional Coder - Hospital (CPC-H(R)) or Certified Risk Adjustment Coder (CRC) EXPERIENCE: + Experience with Cerner and ... **Description** This position is incentive eligible. **Introduction** The Regional Coding Operations Manager (RCOM) is responsible for assisting in the development… more
- Bloomberg (Washington, DC)
- Bloomberg Economics - GeoEconomics - Country Risk Analyst **Washington, DC** Posted Mar 20, 2024 - Requisition No. 123986 With close to 50 economists and 200 ... and policy. We are seeking an expert on country risk analysis to join our growing team. **THE ROLE:**...+ A degree in economics, political science, international relations, regional studies or a related field. A graduate degree… more
- Trinity Health (Mason City, IA)
- …experience. + Preferred: In addition, Certified E&M Coder (CEMC), including Certified Risk Adjustment Coder (CRC) or Certified Documentation Expert Outpatient ... using performance resolution process as needed. + Oversees retrospective and prospective medical record documentation audits of all regional network providers… more
- CVS Health (Columbus, OH)
- …capture. Identifies opportunities to promote quality. Shares best practices in risk adjustment across all sites/regions. Simultaneously manages multiple, complex ... ensuring accurate, timely, and quality clinical documentation in the medical record to reflect the health status of patients...- CPC AAPC or CCA AHIMA certification- 3+ years risk adjustment experience in Medicare advantage or… more
- Commander, Navy Installations (Norfolk, VA)
- Summary Serve as a Non- medical Clinical Counselor within Commander, Navy Installations Command (CNIC), Fleet and Family Readiness Department (N9), Family Readiness ... couples, families, and groups on family dynamics, parent-child interaction, adjustment to commonly occurring personal and family issues/circumstances, adjustment… more
- Commander, Navy Installations (Kings Bay, GA)
- Summary Incumbent serves as a Non- medical Clinical Counselor within Commander, Navy Installations Command (CNIC), Fleet and Family Readiness Department. The primary ... purpose of this position is to provide non- medical clinical counseling to individuals, couples, families, and groups on family dynamics, parent-child interaction,… more
- Bristol Myers Squibb (Madison, NJ)
- …if needed) the planning of USM timelines, resources, and budgets, and develop risk - adjustment model to allow better forecasting of committed spending. Forecast ... and ethical, governmental, and regulatory requirements. + Experience in establishing regional /global medical , publication and brand plans + Knowledge of… more
- Molina Healthcare (Albuquerque, NM)
- …regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... for mental health and chemical dependency services. Works closely with the Regional Medical Directors to standardized utilization management policies and… more
- AdventHealth (Maitland, FL)
- …in understanding professional and facility claims and managed care concepts such as risk adjustment , capitation, FFS, DRG, APG, APCs and other payment mechanisms ... at the office (Altamonte Springs,FL)** **The role you'll contribute:** A Senior Medical Economics analyst is responsible for analyzing and evaluating financial and… more
- Centene Corporation (Jacksonville, FL)
- …Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment . Provides education for HEDIS measures, appropriate medical record documentation ... on workplace flexibility. Position will require up to 50% regional travel and candidate must reside in Jacksonville, Florida...+ Collects, summarizes, trends, and delivers provider quality and risk adjustment performance data to identify and… more
- Mitsubishi Chemical Group (Jersey City, NJ)
- …120-day safety updates for regulatory approval filings. + Interacts extensively with regional and corporate departments to provide medical /drug safety strategic ... respected - is a research-driven pharmaceutical company that has tirelessly pursued medical breakthroughs with global reach. MTPC has discovered and produced several… more
- Bristol Myers Squibb (Chicago, IL)
- …in their personal lives. Read more: careers.bms.com/working-with-us . **Position:** Medical Science Liaison, Neurology **Location** : Field - Illinois/Wisconsin The ... primary role of the Medical Science Liaison (MSL) is to engage in meaningful...peer-to-peer scientific dialogue with healthcare system leaders such as Regional Thought Leaders (RTLs), National Thought Leaders, and Healthcare… more
- Bristol Myers Squibb (Trenton, NJ)
- …Trials and Real-World Evidence). The role collaborates with colleagues on capturing medical insights and acts as a therapeutic area resource to cross-functional ... partners. Engagement with TLs should be aligned with medical strategies, and the role should provide insight back...office to inform strategy. This role is field-based and regional in scope. It is anticipated that the employee… more
- CVS Health (Columbus, OH)
- …treatment protocols for DSNP/MMP and other complex health populations to optimize risk adjustment , clinical quality, and care management* Actively participate in ... person as needed* Outward facing position to interact and collaborate with medical / physical professional associates, the local provider community, state regulatory… more