- Centene Corporation (Jefferson City, MO)
- …2 oversight of Risk Adjustment activities, to include identifying compliance risks, auditing coding practices, adherence to CMS guidelines and supports ... compliance coding practices. + Implement CMS risk adjustment guidelines to support accurate ...risk adjustment guidelines to support accurate coding and compliance with regulatory standards. +… more
- Centene Corporation (Jefferson City, MO)
- … coding guidelines. + Validate clinical documentation to support appropriate risk adjustment coding , including Hierarchical Condition Categories (HCCs), ... execute Line 2 oversight to evaluate the effectiveness and compliance of risk adjustment quality...reviews and advise on clinical best practices related to risk adjustment coding , HCC capture,… more
- MVP Health Care (Tarrytown, NY)
- …to educate providers on coding compliance and consistency. + Works with the Coding Leader of Risk Adjustment to ensure coding compliance ... if you have a passion for accuracy, quality, and compliance coding . **What's in it for you:**...- Certified Coding Specialist (Physician), and CRC-Certified Risk Adjustment Coding Credential required.… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …play a critical role in ensuring the accuracy, completeness, and compliance of risk adjustment coding across both internal teams and external partners. ... healthcare data. Your Responsibilities * Ensure accuracy and compliance of risk adjustment coding , including the appropriate coding of diagnoses and… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …staff. + Participate in strategic cross functional coding projects to enhance risk adjustment performance and compliance . + Mentors and supports new ... we encourage you to apply! Job Description: Summary The Risk Adjustment Coding Coordinator is...meets assigned internal project deadlines and all strict regulatory Risk Adjustment deadlines. + Maintain compliance… more
- Redeemer Health Home Care & Hospice (Huntingdon Valley, PA)
- …professional journey. We invite you to apply today. SUMMARY OF JOB The Certified Risk Adjustment Coding /Audit Reviewer is a physician facing position and ... and communicate documentation deficiencies to providers to improve documentation for accurate risk adjustment coding . Knowledge of anatomy, pathophysiology,… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Operations Supervisor supports the execution of the corporate coding strategy across ... conditions from the accurate collection, submission, and validation of risk adjustment data. Ensuring compliance ...ACA, and state-specific regulations. Remain current on changes to risk adjustment models and coding … more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Specialist supports the retrospective risk adjustment supplemental filing, Risk ... to coding and documentation guidelines. The development and ongoing maintenance of the Risk Adjustment Coding guidelines, as well as, guiding junior … more
- Datavant (Juneau, AK)
- …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...+ Reduction in time taken to create and operationalise coding projects + Maintenance of compliance with… more
- Datavant (Boise, ID)
- … Supervisor serves as a working supervisor with oversight and management of Risk Adjustment team members. This includes monitoring production and quality of ... daily basis, including education on time management and best coding practices. + Provide coaching and feedback on achieving...resource and subject matter expert to staff. + Ensure compliance with HIPAA regulations and requirements. + Completes all… more
- Centene Corporation (Raleigh, NC)
- …models to detect coding patterns and relevant events. + Present findings to Risk Adjustment , Legal, Compliance , and executive teams. + Automate processes ... to identify high risk areas and potential non- compliance . + Develop models to detect coding ...data warehouse, coding or ETL required Medicare Risk Adjustment experience preferred **Project Management or… more
- Centene Corporation (Jefferson City, MO)
- …years Audit, risk adjustment and/or compliance required + Risk Adjustment /HCC coding required + Medicare experience required + Demonstrated ... remote from home anywhere in the Continental United States.** **Position Purpose:** Supports the Risk Adjustment Compliance program elements, with a focus on… more
- Ankura (New York, NY)
- …of activities: + Help clients manage proactive and reactive Medicare and Commercial Risk Adjustment compliance , audit, and investigation projects for ... 8+ years of experience in Medicare Risk Adjustment operations, internal audit, or compliance either...collection and submission activities as well as knowledge of Risk Adjustment coding requirements preferably… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …to ensure data integrity, accuracy, completeness and adherence to leading practices in risk adjustment coding . * Identifies external partner opportunities, ... is a key leader responsible for shaping risk adjustment strategies, delivering executional excellence, ensuring regulatory compliance , and leveraging… more
- Blue KC (Kansas City, MO)
- …Blue KC Risk Adjustment (RA) programs for Commercial (ACA). Manages Risk Adjustment coding , auditing and retrieval operations and if needed special ... within the risk adjustment programs. **Job Description** + Manage all risk adjustment coding and chart retrieval activities to support retrospective… more
- HCA Healthcare (Campbell, CA)
- …direct employee training and provider outreach programs to improve Risk Adjustment and Quality program performance + Ensure compliance with all timekeeping ... impacting our communities. As a Director of Quality and Risk Adjustment with HCA Healthcare, you can...network physicians + Ensure internal HCC coders meet minimum coding performance guidelines + Evaluate and oversee the development… more
- Providence (Portland, OR)
- …remotely in the states of WA, OR and CA. **The Role:** As the Director of Risk Adjustment and Strategic Accounts at Providence Health Plan, you will be the ... cornerstone of our strategic vision. You will oversee risk adjustment programs, spearhead provider education, and enhance engagement to support value-based… more
- Point32Health (Canton, MA)
- …Point32Health (https://www.point32health.org/) . **Job Summary** This position will lead the Risk Adjustment Operations & Provider Consulting team responsible ... provider engagement and consultation activities supporting the complete and accurate capture of risk adjustment data. To be successful, the Manager will need to… more
- CareFirst (Baltimore, MD)
- …project milestones and key deliverables. Develop tracking and monitoring mechanisms for all Risk Adjustment and Coding programs. Support management in ... **Knowledge, Skills and Abilities (KSAs)** + Deep knowledge of regulatory compliance and risk adjustment program integrity. + Experience developing &… more
- Avera (Sioux Falls, SD)
- …initiatives. **What you will do** + Understand the rationale behind Risk Adjustment Work with physicians, clinic staff, coding , and other Health Plans staff ... where you matter.** **A Brief Overview** Responsible for activities focused around Risk Adjustment (RA) initiatives and Healthcare Effectiveness Data Information… more