- Talent Connect Now (San Diego, CA)
- POSITION SUMMARY The Medical Director is responsible for the delivery of participant care, clinical outcomes, and the implementation, as well as oversight, of ... the quality assessment and performance improvement (QAPI) program. The Medical Director serves as the lead in...guide the successful collection, submission, and analysis of diagnostic risk adjustment data. Reviews coding and demographic… more
- Caliber Sourcing (Bothell, WA)
- …for setting strategy and prioritizing network level initiatives. The Associate Director , Operational Excellence leads and manages an operational excellence team to ... understanding of cGMP regulations and FDA guidance applicable to biologics or medical device. Strong business acumen, judgment, and maturity with ability to connect… 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...system. Promote innovative and efficient approaches to validation, incorporating risk -based elements and considerations unique to cell therapy production.… more
- UnitedHealth Group (Phoenix, AZ)
- Optum AZ is seeking a AZ Network Medical Director to join our AZ Network team. Optum is a clinician-led care organization that is changing the way clinicians ... from a high touch model of care. The IPA Medical Director in AZ will report to...oversight and direction of Outpatient Care Management Services, Medicare Risk Adjustment Factor (RAF) education as well… more
- CVS Health (Chicago, IL)
- …it all with heart, each and every day. Company: Oak Street Health Title: Senior Medical Director Location: Varies Role Description: The Senior Medical ... Street Health leading the transition from fee-for-service to value-based care. The Senior Medical Director will be responsible for leading our provider teams in… more
- UnitedHealth Group (Secaucus, NJ)
- Optum East (formerly Optum Tri-State NY) is seeking a Associate Medical Director , Network Partnerships to join our team in for NY/NJ Optum is a clinician-led ... The Optum Health East region is seeking an experienced medical director to support our care transformation...this key physician will provide expertise in population health, risk adjustment and quality. They will work… more
- Banner Health (Phoenix, AZ)
- …Clinical Decision Making Work Shift: Day Job Category: Physicians The Senior Medical Director , Network Performance is a senior clinical executive responsible ... This role leads enterprise strategies to improve cost efficiency, quality outcomes, risk adjustment accuracy, and contract performance across lines of business… more
- State of Indiana (Elkhart, IN)
- …the incident is substantiated, and develop recommendations to a Juvenile Court or County Director for disposition. Assess the level of risk to the child for ... develop briefing reports for the community child protection team. Develops "informal adjustment " plans with families and children to divert children from the… more
- St. Luke's University Health Network (Bethlehem, PA)
- …RN care managers, assistants, coordinators, utilization management staff, and director . Facilitates communication among all treatment team members. Manages length ... patient as healthy as possible in the outpatient setting, minimizing the risk of readmissions. Issues applicable state/federal regulatory notices as applicable ie.)… more
- Community Care Network (Rutland, VT)
- …other interagency programs. Maintain close communication with the consulting psychiatrist, Medical Director and/or nurse for input regarding medication ... as alert required members of the staff of any changes in client adjustment which might suggest decompensation and a need for more aggressive intervention. Engage… 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 ... Day Moving Forward Our Promise Purpose Driven Career Competitive Pay Best-In-Class Medical /Dental Coverage Free Mental Health & Life Coaching for Team Members and… more
- Salvation Army (Centralia, WA)
- …: The Coordinated Entry Lead works with the Shelter Manager, Social Services director , hygiene center attendant, as well as Coordinated Entry Worker to provide ... services for persons who are homeless or at imminent risk of homelessness. Enter persons into the Homeless Management...person with a disability may request a modification or adjustment to the job or work environment in order… more
- Actalent (Baltimore, MD)
- …Manufacturing Engineering, Electrical Engineering specializations. Reporting to our tenured Director of Financial Operations, the Sr. Financial Operations Manager ... provide necessary reporting to leadership. Partner with executive leadership to support risk management and risk mitigation strategies. Lead direct reports with… more
- California State University (San Luis Obispo, CA)
- …CAPS provides outreach, educational services, and campus consultations. Reporting to the Director of CAPS, this position provides a range of clinical services for ... populations. Demonstrated knowledge of FERPA, HIPAA, and the California Medical Information Act as it relates to the provision...business hours, or on weekends. Occasional holiday work and adjustment to normal working hours to meet special jobs… 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...offer comprehensive package of benefits including paid time off, medical /dental/vision insurance, 401(k), and a suite of well-being benefits… 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
- Corewell Health (Grand Rapids, MI)
- Job Summary The Director Risk Adjustment Prospective...7 years of relevant experience in Risk Adjustment in a health plan or medical ... strategic leader who initiates, develops and executes/implements the multi-product risk adjustment strategy set by the executive...member disease burden after the point of care.3. Mitigate risk by identifying opportunities in the medical … 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...exemptions may be available on the basis of disability, medical contraindications to the vaccine or any of its… 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
- Tufts Medicine (Burlington, MA)
- …as other technical requirements. 4. Summarizes and interprets audit findings for Director Risk Adjustment Operations/NEQCA Leadership; tracks audit results ... overall provider documentation as it pertains to coding and risk adjustment guidelines. Reviews medical ...identifies trends, and recommends corrective actions. 5. Collaborates with Director Risk Adjustment Operations/NEQCA staff… more
