- Humana (Columbus, OH)
- …Experience in healthcare interoperability, including FHIR + Familiarity with CMS Risk Adjustment and Quality Measure reporting + Proven track record with ... need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel,… more
- CareFirst (Baltimore, MD)
- …member outreach for appointment scheduling and collaborates with provider to ensure closure of quality and risk adjustment gaps in care. Consults on proper ... partnership with provider entities and guidance on the appropriate quality measure capture and all chronic conditions...Supports to use of alternatives and solutions to maximize quality payments and risk adjustment .… more
- Bloomberg (Washington, DC)
- …sets and models that provide a more systematic way of understanding countries' geoeconomic risk exposure. We'll measure success by the breadth and depth of our ... Bloomberg Economics - GeoEconomics - Country Risk Analyst **Washington, DC** Posted Mar 20, 2024...the initiative to provide a consistent flow of original, high- quality analysis and to operate in a fast-paced, dynamic… more
- PNC (Pittsburgh, PA)
- …& Model Development Group Manager Senior you will be a member of the Independent Risk Management team reporting to PNC's Chief Model Risk Officer. This position ... an accomplished Senior Validation Manager to lead our Market Risk Model and Counterparty Credit Risk Model...models, such as Potential Future Exposure (PFE), Credit Valuation Adjustment (CVA), and Funding Valuation Adjustment (FVA).… more
- Bloomberg (New York, NY)
- Risk & Valuations Sales Specialist (BVAL), Specialist Sales - Bloomberg Financial Solutions **New York, NY** Posted Mar 15, 2024 - Requisition No. 123852 Bloomberg ... work with the same information, the entire enterprise benefits. Bloomberg's Enterprise Risk & Valuation services deliver that consistency! From our high- quality … more
- PNC (Tysons Corner, VA)
- …the company's success. As a Quantitative Analytics/Modeling Consultant within PNC's Model Risk Management organization, you can be based in Pittsburgh, PA or Tyson's ... validation of a mix of the following models: derivative pricing models, Value at Risk (VaR) models, asset and liability models measuring interest rate risk and… more
- Highmark Health (Columbus, OH)
- …(such as quality and compliance), and/or physicians to identify and deliver high quality and accurate risk adjustment coding. Supports all risk ... Centers for Medicare and Medicaid Services (CMS) coding guidelines, and support of Risk Adjustment Data Validation (RADV) audits. Works closely with colleagues,… more
- Actalent (Foster City, CA)
- …QMS quality improvement activities, with a focus on design controls and risk management. * Provide oversight of quality improvement activities and ensure ... product development and provide input into the design controls process. Skills: Risk management, quality management system, iso 13485, medical device, design… more
- Bloomberg (New York, NY)
- …tech breakthrough; we work hard, and we work fast - while keeping up the quality and accuracy we're known for. It's what keeps us inventing and reinventing, all the ... you to make it happen. **What's the role?** Robust risk management is an ongoing point of differentiation and... Indicators to create standards and the ability to measure performance towards standards + Engage with internal stakeholders… more
- Actalent (Santa Clara, CA)
- … and safety signals associated with product performance, and overall aspect of the Quality Management System (QMS) and Risk Management System * Assist functional ... Description: Position Overview The Quality Data Analyst II will establish, collect, analyze,...* Assist in establishing Key Performance Indicators (KPIs) to measure effectiveness of the QMS processes * Identify and… more
- Centene Corporation (Springfield, IL)
- …+ Collaborates with Provider Relations to improve provider performance in areas of Quality , Risk Adjustment and Operations (claims and encounters). + ... supports provider practice sites in regards to the National Committee for Quality Assurance (NCQA) HEDIS measures. Provides education for HEDIS measures, appropriate… more
- Magellan Health Services (Newtown, PA)
- …and local leadership to drive clinical analytics relative to risk adjustment (Medicare HCC, Medicaid CDPS-Rx), Quality (HEDIS/STARS), risk stratification ... matter expertise for one or more of the following: Risk Adjustment for CMS HCC Medicare Advantage...Rx, Milliman, Mercer), Quality (HEDIS / STARS) measure performance, Population Health including population segmentation, risk… more
- Bloomberg (New York, NY)
- …shocks to the CGE model and to other relevant analytical approaches. + We'll measure success by the relevance, timeliness and quality of your quantitative ... shocks and their macroeconomic implications. + Collaborate with editors to publish high- quality analysis on the Bloomberg Terminal. + Partner with country desks and… more
- Bloomberg (New York, NY)
- …tech breakthrough; we work hard, and we work fast - while keeping up the quality and accuracy we're known for. It's what keeps us inventing and reinventing, all the ... closely with stakeholders to inform business strategy, define strategic priorities and measure success + Support development and track performance of business plans… more
- Actalent (Tigard, OR)
- …Collaborates with Provider Relations to improve provider performance in areas of Quality Risk Adjustment Operations claims and encounters. Schedules ... provides education for HEDIS measures and coding. Supports the implementation of quality improvement interventions and audits in relation to plan providers. Assists… more
- Actalent (Tigard, OR)
- …+ Collaborates with Provider Relations to improve provider performance in areas of Quality Risk Adjustment Operations claims and encounters. + Schedules ... years of experience in direct patient care, social work, quality improvement, or health coaching, preferably in a managed...+ Experience with member outreach. + Basic understanding of measure specs. + EMR/EHR experience. + Proficiency with MS… more
- Humana (Columbus, OH)
- …stability and effectiveness for market-based processes that support Provider Engagement, Quality /Stars, Interoperability, and Medicare Risk Adjustment (MRA) ... + Collaborate with enterprise partners to develop KPIs and activities to measure operating model performance, adherence, and productivity + Partner with owners of… more
- Actalent (Boca Raton, FL)
- …using the Stage Gate approach from feasibility to project close-out. Measure project performance using appropriate systems, tools and techniques, evaluate ... priorities to be applied to assigned projects and perform risk management activities to minimize project risks. * Direct...all change control activities/ deviations as required by our Quality Systems, OSHA etc. * Perform design reviews and… more
- Fresenius Medical Center (Evergreen Park, IL)
- …ease patients into dialysis. The first weeks of dialysis involve a great deal of adjustment , along with increased risk of hospitalization and mortality. As a TCU ... opportunities and measure the progress of improvement projects. + Use quality improvement tools to ensure adherence to QAI activities. + Facilitates program and… more
- ChenMed (Miami, FL)
- …and revenue is attributed to enterprise. + Manage end to end process from Risk Adjustment to claim submission. + Will be accountable stakeholder for the ... management as well as end to end revenue cycle management. As a delegated full- risk company, ensuring we obtain all potential premium dollars from our payor partners… more