- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …Blue Cross and Blue Shield of Minnesota Position Title: Quality & Risk Adjustment Provider Consultant Location: Hybrid | Eagan, Minnesota Career ... -performance consultation team, this role * Identifies opportunities for provider groups to improve performance on quality ...-facing or leadership-facing experience * Knowledge of Health Care Quality measures * Certified Risk Adjustment… more
- Avera (Sioux Falls, SD)
- … Adjustment (RA) initiatives 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...Quality Coordinator - HEDIS. + Supports member and provider outreach initiatives to close quality and… more
- Centene Corporation (Jefferson City, MO)
- …execute Line 2 oversight to evaluate the effectiveness and compliance of risk adjustment quality programs. + Provide expert guidance on CMS coding ... and communicates findings to business stakeholders to support the integrity and quality of risk adjustment data. Collaborates with coding teams to improve… more
- BJC HealthCare (St. Louis, MO)
- …to be successful in the role: + **Hierarchical Condition Category (HCC)** **coding and risk adjustment ** + **Bachelors degree** + **2 years in a supervisory ... Illinois areas. Our providers are nationally recognized for excellent patient satisfaction, quality health care, and improving the health and well-being of the… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …are ready to make a difference, join us. The Impact You Will Have As a Risk Adjustment Quality Assurance (QA) Consultant at BCBSMN, you'll play a critical ... protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Risk Adjustment QA Consultant Location: Hybrid | Eagan, Minnesota Career… more
- Centene Corporation (Springfield, IL)
- …federal, and NCQA requirements. + Collects, summarizes, trends, and delivers provider quality and risk adjustment performance data to identify and ... to improve provider performance in areas of Quality , Risk Adjustment and Operations...encounters). + Identifies specific practice needs where Centene can provide support. + Develops, enhances and maintains provider… more
- Centene Corporation (Indianapolis, IN)
- …federal, and NCQA requirements. + Collects, summarizes, trends, and delivers provider quality and risk adjustment performance data to identify and ... to improve provider performance in areas of Quality , Risk Adjustment and Operations...encounters). + Identifies specific practice needs where Centene can provide support. + Develops, enhances and maintains provider… more
- Centene Corporation (Austin, TX)
- …federal, and NCQA requirements. + Collects, summarizes, trends, and delivers provider quality and risk adjustment performance data to identify and ... to improve provider performance in areas of Quality , Risk Adjustment and Operations...encounters). + Identifies specific practice needs where Centene can provide support. + Develops, enhances and maintains provider… more
- Molina Healthcare (Rock Hill, SC)
- …role implements Health Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider ... providers have a Provider Engagement plan to meet annual quality & risk adjustment performance goals. * Drives provider partner coaching and… more
- Molina Healthcare (Iowa City, IA)
- …Transformation implements Health Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider ... plan to meet annual quality & risk adjustment performance goals. + Drives provider partner coaching and collaboration to improve quality performance… more
- Centene Corporation (Lansing, MI)
- …with Provider Relations to improve provider performance in areas of Quality , Risk Adjustment and Operations (claims and encounters). + Assists in ... communication such as newsletter articles, member education, outreach interventions and provider education. + Supports quality improvement HEDIS and program… more
- CareFirst (Baltimore, MD)
- …schedule for delivering results of analyses to improve awareness and understanding of risk adjustment results and quality , accuracy and identification of ... solve problems, provide data-driven guidance, and monitor risk adjustment performance. Provide analytical...developing materials and presenting key updates to leadership regarding risk adjustment programs and provider … more
- Point32Health (Canton, MA)
- …to the Director of Risk Adjustment Strategy, Operations and Quality Assurance. **Job Description** + ** Provider Consulting, Risk Score Reporting ... (https://www.point32health.org/) . **Job Summary** This position will lead the Risk Adjustment Operations & Provider ...ad hoc) analyses to improve awareness and understanding of risk adjustment results and the quality… more
- Humana (Topeka, KS)
- …standards. + Collaborate with Stars program teams to manage vendor activities tied to quality and risk adjustment goals. + Operate independently, make ... with CMS guidelines-all while supporting Humana's Retail bid goals and Medicare Risk Adjustment requirements. This role requires strong task management, project… more
- Mount Sinai Health System (New York, NY)
- …CDQI, who will (1) be responsible for driving key population health goals including access, quality , utilization and accurate risk adjustment with a group of ... and research/education. We have ~40,000 employees working together to provide billions of dollars in high- quality care...hardwiring processes to drive excellence in efficiency of care, quality and accurate risk adjustment … more
- Centene Corporation (Columbus, OH)
- …with Provider Relations to improve provider performance in areas of Quality , Risk Adjustment , Operations (claims and encounters). + Schedules doctor ... barriers to care are removed, and improve the overall member and provider experience through outreach and face-to-face interaction with members and providers at… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Manager plays a critical role in the development and execution of the corporate risk adjustment ... the end to end strategy by applying improvements and driving cost-effective risk adjustment actions across all organizational populations and products.… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Operations Supervisor supports the execution of the corporate coding strategy across Medicare ... risk conditions from the accurate collection, submission, and validation of risk adjustment data. Ensuring compliance with regulatory standards that ensure… more
- CareFirst (Baltimore, MD)
- …for different financial and incentive models. Strategizes alternatives and solutions to maximize quality payments and risk adjustment . Translates from claim ... **Education Level:** High School Diploma or GED. **Experience:** 5 years experience in risk adjustment coding, ambulatory coding and/or CRC coding experience in… more
- Henry Ford Health System (Detroit, MI)
- …maximize accurate reimbursement. + Support initiatives for quality reporting, risk adjustment , provider education, and regulatory compliance. Innovation, ... Henry Ford Health, precision and integrity in coding are essential to delivering high- quality care and ensuring the financial strength of our system. As the Director… more