- Monster (Allentown, PA)
- …to pay for health care. The Registered Nurse or Social Worker Care Manager is responsible for coordinating the complex discharge planning needs of patients, as ... patient as healthy as possible in the outpatient setting, minimizing the risk of readmissions. Issues applicable state/federal regulatory notices as applicable ie.)… more
- Monster (Sellersville, PA)
- …of a patient's ability to pay for health care. The Social Worker Care Manager is responsible for coordinating the complex discharge planning needs of patients, as ... patient as healthy as possible in the outpatient setting, minimizing the risk of readmissions. Issues applicable state/federal regulatory notices as applicable ie.)… more
- Datavant (Providence, RI)
- …life experiences to realize our bold vision for healthcare. **Role Overview** As a Product Manager , Risk Adjustment Coding Data Integration, you will own the ... data strategy and execution for Datavant's Retrospective Risk Adjustment Coding products, driving client data standardization, data integrations, database… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Manager plays a critical role in the development and execution of the corporate risk ... the end to end strategy by applying improvements and driving cost-effective risk adjustment actions across all organizational populations and products.… more
- Molina Healthcare (St. Petersburg, FL)
- … Manager - Provider Engagement** plays a key role in driving risk adjustment and quality performance outcomes through effective program management, ... Development** + Develop, review, and update Standard Operating Procedures (SOPs) for risk adjustment and quality program workflows. + Maintain accurate,… more
- LA Care Health Plan (Los Angeles, CA)
- Enterprise Risk Adjustment Analyst III Job Category: Accounting/Finance Department: Risk Adjustment Strategies & Initiatives Location: Los Angeles, CA, ... to support the safety net required to achieve that purpose. Job Summary The Enterprise Risk Adjustment Analyst III provides a key leadership role in the Risk… more
- ChenMed (Miami, FL)
- …We're rapidly expanding and we need great people to join our team. The Risk Adjustment Coder works in a collaborative effort directly with physicians and ... to review medical records and other clinical documentation to identify appropriate risk adjustment codes and quality gap closure opportunities. A major… more
- Ankura (Los Angeles, CA)
- …deliver work and seeks to gain additional opportunities for development in a variety of risk adjustment related areas. Qualifications: + Certified in Risk ... (CRC) with at least five (5) recent years of experience in HCC/ Risk Adjustment and/or RADV Audit Methodology + Associate's or Bachelor's degree preferred, but… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …to blue. Position Summary: This role will provide analytical support to the Risk Adjustment Operations team. We're seeking a detail-oriented, curious, and ... throughout program cycles. + Manage data requirements for different Risk Adjustment activities such as in-home health...and in written format. + Work closely with the Manager and broader analytics team to collaborate on analyses… more
- Elevance Health (Grand Prairie, TX)
- **Medicare Risk Adjustment Advanced Analyst Senior** **Location:** This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and ... dynamic and adaptable workplace. Alternate locations may be considered. The **Medicare Risk Adjustment Advanced Analyst Senior** is responsible for creating… 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
- Datavant (Hartford, CT)
- …mouse, etc + Comprehensive training led by a credentialed professional coding manager + Exceptional service-style management and mentorship (we're in this together!) ... Pay ranges for this job title may differ based on location, responsibilities, skills, experience, and other requirements of the role. The estimated base pay range per hour for this role is: $27-$28 USD To ensure the safety of patients and staff, many of our… more
- Molina Healthcare (Kearney, NE)
- …SKILLS & ABILITIES:** * 2+ years of program and/or project management experience in risk adjustment and/or quality * 2+ years of experience supporting HEDIS ... **Job Description** **Job Summary** The Risk & Quality Performance Manager position...engine activity, risk adjustment targeting and reporting systems *… more
- Amazon (Seattle, WA)
- Description Join Amazon as a Risk Manager - Shape the future of Risk and Governance in Finance Operations Amazon is seeking a Risk Manager to join ... Earth's most customer-centric company. Key job responsibilities As a Risk Manager , you will be the go-to...have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support… more
- Bristol Myers Squibb (Tampa, FL)
- …. Bristol Myers Squibb (BMS) is seeking a candidate for the position of Manager , Third Party Risk Management (TPRM) - Global Procurement. The Manager ... TPRM plays a supportive role in BMS's third party risk management program under the direction of the Director...in their roles. Applicants can request a reasonable workplace accommodation/ adjustment prior to accepting a job offer. If you… more
- Healthfirst (NY)
- …from an accredited institution. + At least 5 years previous work experience within risk adjustment + Credentialed Associate of the Society of Actuaries (ASA) + ... supporting Product and Actuarial analytical requests. + Experience with CMS/HHS risk adjustment payment methodologies. + Self-motivated, creative problem solver… more
- Bristol Myers Squibb (Indianapolis, IN)
- …RayzeBio aims to be the global leader in radiopharmaceuticals. **Summary** The Senior Manager , Compliance and Quality Risk Management at RayzeBio serves as the ... Local Process Owner for Risk Management and Data Integrity, responsible for driving consistent,...in their roles. Applicants can request a reasonable workplace accommodation/ adjustment prior to accepting a job offer. If you… more
- Bristol Myers Squibb (New Brunswick, NJ)
- …personal lives. Read more: careers.bms.com/working-with-us . **Position Summary** The Senior Manager , Operational Risk Management will be responsible to enhance ... QRM capabilities for key Quality Risk Management (QRM) processes within the GxPs (GMP, GDP,...in their roles. Applicants can request a reasonable workplace accommodation/ adjustment prior to accepting a job offer. If you… more
- New York State Civil Service (Albany, NY)
- NY HELP No Agency Financial Services, Department of Title Senior Manager , Data Architecture (Financial Services Specialist 4 ( Risk ), SG-27) Occupational Category ... the stability of the global financial system.The Financial Services Specialist 4 ( Risk ) will be responsible for developing and implementing strategies to monitor … more
- Amazon (Charleston, SC)
- Description Amazon Books is seeking a Books Risk Management (BRM) Risk Prevention Program Manager to lead our most complex root cause investigations and ... corrective action definition, and drives the roadmap for a strategic risk problem space. You'll tackle systemic issues affecting authors, publishers, and… more
