- Talent Connect Now (San Diego, CA)
- …other leaders to guide the successful collection, submission, and analysis of diagnostic risk adjustment data. Reviews coding and demographic files to ensure ... POSITION SUMMARY The Medical Director is responsible for the delivery of participant...and the implementation, as well as oversight, of the quality assessment and performance improvement (QAPI) program. The Medical… more
- Bristol-Myers Squibb Company (Summit, NJ)
- …and in their personal lives. Read more: careers.bms.com/working-with-us. Position Summary Director of Validation, Cell Therapy Technical Operations reports to the ... Senior Director , Cell Therapy Technical Operations within the Cell Therapy...deploy global cell therapy validation technical standards via the quality system. Promote innovative and efficient approaches to validation,… more
- UnitedHealth Group (Phoenix, AZ)
- …to ensure accurate diagnostic codes in order to maximize risk adjustment (RAF) Preferred Qualifications: 2+ years of Quality Management experience Experience ... Optum AZ is seeking a AZ Network Medical Director to join our AZ Network team. Optum...agendas/strategies and leading multifaceted teams of Physician Business Managers, Risk Adjustment RNs, and Quality … more
- Memorial Healthcare (Owosso, MI)
- JOB SUMMARY Reports to the Director . Has 24-hour responsibility for the management of nursing personnel, ancillary personnel, and patient care in the assigned ... Develops unit based QI initiatives annually and participates in organizational quality initiatives (ie, core measures, HCAHPS, Value Based Purchasing, and Employee… more
- CVS Health (Chicago, IL)
- … Improvement Utilization Management Network Management Health Plan Management Documentation/ Risk Adjustment Clinical Compliance & Policy Development This ... heart, each and every day. Company: Oak Street Health Title: Senior Medical Director Location: Varies Role Description: The Senior Medical Director will join… more
- UnitedHealth Group (Secaucus, NJ)
- …, Population Health, this key physician will provide expertise in population health, risk adjustment and quality . They will work collaboratively across ... in teaching clinicians and clinical operations teams about Medicare Risk Adjustment , CMS STARs/HEDIS, and overall population...urgent care centers, within care models focused on managing risk , higher quality outcomes and driving change… more
- Banner Health (Phoenix, AZ)
- …value-based programs. This role leads enterprise strategies to improve cost efficiency, quality outcomes, risk adjustment accuracy, and contract performance ... Decision Making Work Shift: Day Job Category: Physicians The Senior Medical Director , Network Performance is a senior clinical executive responsible for advancing… more
- Suvida (Phoenix, AZ)
- …setting (primary care or Medicare Advantage Plans preferred) 2+ years of HEDIS or Risk Adjustment experience in supplemental data and chart reviews Knowledge of ... caps. The Quality Care Analyst will also work with the Director of Quality to report low clinic engagement, opportunities for staff education, and reporting… more
- St. Luke's University Health Network (Bethlehem, PA)
- …multi-disciplinary care teams to facilitate the achievement of desired patient, quality , and financial outcomes. JOB DUTIES AND RESPONSIBILITIES: Develops a ... RN care managers, assistants, coordinators, utilization management staff, and director . Facilitates communication among all treatment team members. Manages length… more
- Ellie Mental Health (Clinton Township, MI)
- …in Clinton Township, you'll share our vision for improving and expanding access to quality mental health care and thrive in an environment driven by our core values ... families. We offer regular one-on-one meetings with the clinical director , monthly team meetings, and ongoing professional development opportunities. Part-time… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …transform healthcare? Bring your true colors to blue. Under the direction of the Senior Director of Medicare Risk Adjustment and Analytics, the Associate ... Director of Risk Adjustment Data and Analytics is responsible...scripting, macros) preferred + Demonstrated attention to detail, delivering quality results and operating collaboratively as part of a… more
- CareFirst (Baltimore, MD)
- … across the organization within Medicare Advantage, Medicaid & ACA markets. The Risk Adjustment Director is responsible for strategic direction, leadership, ... **Resp & Qualifications** **PURPOSE:** The Director , Risk Adjustment oversees...as an SME to guide CareFirst's VP of Enterprise Quality & Risk Adjustment , Finance,… more
- Corewell Health (Grand Rapids, MI)
- Job Summary The Director Risk Adjustment Prospective Operations & Risk Mitigation is the thought leader role responsible for ensuring the complete and ... quality and overall impact of the company's risk adjustment program, including reporting KPIs on...collaboration cross all relevant internal departments/positions that intersect with risk adjustment ( Quality , Provider Relations,… more
- Blue KC (Kansas City, MO)
- …with adoption financial assistance** **Employee discount program** **Job Description Summary:** The Director , Government Programs Risk Adjustment & Audit ... risk adjusted revenue optimization strategy and oversight of Government Programs Risk Adjustment programs. **Job Description** + Interface with Blue KC… more
- Datavant (Honolulu, HI)
- …strategic mindset and a focus on continuous improvement. + Familiarity with CMS HCC risk adjustment processes preferred \#LI-BC1 We are committed to building a ... experiences to realize our bold vision for healthcare. The Director of Client Success will report to the VP...updates, etc.). + Identify project risks that impact the quality of our product and services delivery to clients,… more
- Ankura (New York, NY)
- …college/university + Current Registered Nurse license + Experience working for payors conducting risk adjustment reviews + Clinical experience in a variety of ... and mature their compliance programs, conduct program effectiveness reviews, and risk assessments, and perform compliance audits. We assist in-house and outside… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …Medicare Risk Adjustment Strategy Program Manager will report to the Senior Director of Medicare Risk Adjustment and Analytics. This role will manage ... the process of developing and maintaining the risk adjustment strategic plan. This position will...to multi-task and manage multiple deliverables while demonstrating high quality of work and meeting agreed upon deadlines +… more
- Commonwealth Care Alliance (Boston, MA)
- … Director of Encounter Data Management within the Revenue Cycle Department, the Risk Adjustment Data Developer is responsible for the design, development, and ... of data systems and tools that support Commonwealth Care Alliance's (CCA) risk adjustment and Hierarchical Condition Category (HCC) revenue programs. This… more
- Datavant (Little Rock, AR)
- …to realize our bold vision for healthcare. **What we're looking for:** The incoming Risk Adjustment Analytics Manager will be stepping into a role on the ... manager will collaborate with other managers and the department director to set strategy and mobilize the team to...and management of workloads, communication with stakeholders, and the risk adjustment subject matter expertise necessary to… more
- Bristol Myers Squibb (New Brunswick, NJ)
- …in their personal lives. Read more: careers.bms.com/working-with-us . **Position Summary** The Director , Quality Risk Management will drive consistent Global ... Leadership on Quality Risk Management (QRM), the Risk...BMS network. This position will report into the Senior Director , Risk Management. **Key Responsibilities:** + Provide… more
