- BoldAge PACE (Evansville, IN)
- …Accurately document diagnoses with attention to proper coding practices, supporting risk adjustment and quality reporting metrics. Provide coverage for ... and that continuity of care is maintained. Collaborate with the Medical Director to manage specialist referrals, initiate appropriate treatment prior to referral… more
- Point32Health (Canton, MA)
- …with our corporate and business division goals. This position will report to the Director of Risk Adjustment Strategy, Operations and Quality Assurance. ... Point32Health (https://www.point32health.org/) . **Job Summary** This position will lead the Risk Adjustment Operations & Provider Consulting team responsible… more
- Ankura (New York, NY)
- …operations, investigations, and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment . The Senior Director will also ... of activities: + Help clients manage proactive and reactive Medicare and Commercial Risk Adjustment compliance, audit, and investigation projects for clients. +… more
- Mount Sinai Health System (New York, NY)
- …adjustment with a group of practices and (2) close partnership with the CDQI Director to drive accurate risk adjustment throughout the system. This ... hardwiring processes to drive excellence in efficiency of care, quality and accurate risk adjustment for all populations served, especially our patients covered… more
- Molina Healthcare (MI)
- …Description** **Job Summary** The Director , Clinical Data Acquisition for Risk Adjustment , is responsible for the implementation, monitoring, and oversight ... of all chart collection for Risk Adjustment , RADV, or Risk Adjustment -like projects, and other state specific audit projects and deliverables related to… more
- Avera (Sioux Falls, SD)
- …and Healthcare Effectiveness Data Information Sets (HEDIS). The Quality and Risk Adjustment Specialist will work closely with the Director of Quality and ... Risk Services, Manager of Risk Adjustment , Manager of Quality, Quality Coordinator - HEDIS, coder(s), claims staff, and primary care & specialty care… more
- Basin Electric Power Cooperative (Bismarck, ND)
- Job Title: DIRECTOR /MANAGER, RISK & INSURANCE (DOE) Posting Start Date: 10/3/25 Job Description: **POSITION PURPOSE** This position is open to varying levels of ... risk of loss, planning, managing, and coordinating risk regarding the property, Director and Officer...SKILLS** + Knowledge of property and casualty insurance, claims adjustment , and risk analysis. + Proficient with… more
- Bristol Myers Squibb (New Brunswick, NJ)
- …their personal lives. Read more: careers.bms.com/working-with-us . Job Description The Associate Director , RBQM - HOCT, ICN will mainly be responsible for developing ... critical to quality (CtQ) data, processes, and vendors, demonstrating effective risk and issue management. Provide quality and compliance consultation to clinical… more
- Catholic Health Initiatives (Little Rock, AR)
- …for the value hub. + Through Risk Management/Auditor Manager, implements a risk adjustment coding department in appropriate Arkansas and Kentucky CIN. + ... CIN/Population Health Management experience required + Must have experience with risk adjustment coding and value based reimbursement models of payment +… more
- Bristol Myers Squibb (Madison, NJ)
- …lives. Read more: careers.bms.com/working-with-us . **Position Summary** The Structured Benefit- Risk Assessment (SBRA) Lead will report into the Structured Benefit- ... Risk Assessment Head within Safety Evidence and Sciences and...in their roles. Applicants can request a reasonable workplace accommodation/ adjustment prior to accepting a job offer. If you… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …team responsible for maintaining, executing, and evaluating initiative impacts using the risk adjustment and quality analytics models across ACA Commercial, ... of data submissions for ACA Commercial, Medicare, and Medicaid risk adjustment and quality programs. * Design...Education Required Required Skills and Experience * Accepting this director level position at BCBSMN requires signing an Employee… more
- CenterWell (Tallahassee, FL)
- …interrelate across the function or segment. **Strategy:** + In partnership with AVP, Risk Adjustment and AVP, MRA Strategy, responsible for driving ongoing ... caring community and help us put health first** The Director , Medical Coding extracts clinical information from a variety...Responsible for performance management and strategy development for PCO risk adjustment at the division and market… more
- Point32Health (NH)
- …and will work in a matrix environment collaborating with functions including risk adjustment , population health, finance, operations, actuarial, and sales. **Job ... we are at Point32Health (https://www.point32health.org/) . **Job Summary** The Director of Contracting is responsible for contract strategy, development,… more
- ChenMed (Miami, FL)
- …processes + Comprehensive knowledge of Medicare program including but not limited to Risk Adjustment processes and Fee For Service. + Knowledge of applicable ... need great people to join our team. The Associate Director , Revenue Cycle Management (RCM) Optimization manages and organizes...incumbent also serves as a subject matter expert on risk - adjustment and medical economics to aid in… more
- Bristol Myers Squibb (Princeton, NJ)
- …(GDO), the Director GTL is responsible for critical decision making, risk management, and fostering a culture of innovation and continuous improvement. Works ... their personal lives. Read more: careers.bms.com/working-with-us . **Position Summary** The Director , Global Trial Lead (GTL) is accountable for the strategic… more
- Bristol Myers Squibb (Princeton, NJ)
- …lives. Read more: careers.bms.com/working-with-us . **Position Summary** Reporting to the Director , Inspection Readiness, the Associate Director will help drive ... extensively with teams and leaders across the BMS network. The Associate Director will support BMS' GMP/GDP Inspection Readiness strategy by supporting on-site and… more
- AIG (Atlanta, GA)
- At AIG, we are reimagining the way we help customers to manage risk . Join us as a Complex Claims Director - Aviation to play your part in that transformation. ... position requires the adjustment of complex aircraft damage claims. The Complex Director will function as a key account contact for multiple programs across all… more
- AmeriHealth Caritas (Washington, DC)
- …Enrollment, Contact Center Operations, IT, Provider Configuration Management, Program Integrity, Risk Adjustment , Provider Resolution Team, Provider Appeal and ... **Job Responsibilities** The Director Operations (Healthy DC Plan) reports to the...and identify opportunities for improved profitability, health outcomes, and risk adjustment goals; directs analytical activities to… more
- Bristol Myers Squibb (Seattle, WA)
- …lives. Read more: careers.bms.com/working-with-us . **Position Summary** The Executive Director , Cell Therapy Quality Compliance, is responsible for ensuring robust ... in strict adherence to applicable regulations and BMS standards. The Executive Director leads a team dedicated to maintaining global compliance across the cell… more
- Scripps Health (San Diego, CA)
- …of ICD, CPT, and HCPCS coding systems, MS-DRG/APR-DRG methodologies, and risk adjustment /HCC principles. * Strong technical proficiency and experience ... *This Senior Director position is eligible to participate in the Director Incentive Plan.* *This position is in La Jolla and requires residence in San Diego… more
