- Kaiser Permanente (Oakland, CA)
- Overview: The Prospective Risk Adjustment Operations team is seeking a Program Manager to lead the planning, execution, and oversight of strategic initiatives ... that support prospective Medicare risk adjustment efforts. This pivotal role will be responsible for coordinating cross-functional teams, managing project… more
- Kaiser Permanente (Sacramento, CA)
- Program Manager III Risk Adjustment /Chart Review The Program Manager III for Risk Adjustment and Chart Review is responsible for overseeing the accuracy ... and efficiency of risk adjustment processes and retrospective chart reviews. They will support the management and oversight of internal and vendor chart… more
- Pyramid Consulting, Inc. (Tampa, FL)
- Immediate need for a talented Risk Adjustment Coder. This is a 06+months Contract to Permanent opportunity with long-term potential and is located in US(Remote). ... and has a complete understanding of these guidelines Follows CMS risk adjustment guidelines and has a complete understanding of these guidelines Understands… more
- Advantmed (Portland, OR)
- About Advantmed Advantmed is a leading provider of risk adjustment , quality improvement and value-based solutions to health plans and providers. We drive market ... In this role, you will be responsible for conducting in-home wellness risk adjustment assessments for Medicare members and other at risk populations.… more
- Iconma LLC (Lansing, MI)
- …their Lansing, MI location. Responsibilities: This engagement requires a highly skilled Risk Adjustment Business Analyst who can bridge regulatory requirements ... minimize operational risk , and contribute to the overall success of Risk Adjustment activities by the plan. The ideal candidate will bring a strong… more
- Blue Cross and Blue Shield of Minnesota (St. Paul, MN)
- …cost saving opportunities. Works closely with actuarial, finance, data & analytics, stars, risk adjustment , and other lever owners to gather necessary data for ... performance relative to established contracts. Collaborate with actuarial, finance, Medicare and risk adjustment to ensure all inputs and assumptions leverage… more
- Molina Healthcare (Long Beach, CA)
- …products to coordinate a medical plan of care and capture diagnoses for Medicare risk adjustment . The NP/PA will utilize advanced assessment skills to diagnose ... examination. Capture and document annual diagnoses accurately consistent with Medicare risk adjustment . Conduct comprehensive annual medication reviews and… more
- Cambia Health Solutions (Renton, WA)
- Risk Adjustment : Business Operations Specialist II Work from Home within Oregon, Washington, Idaho or Utah Build a career with purpose. Join our Cause to create ... make health care easier and lives better. As a member of the Risk Adjustment team, our Bus Ops Specialists contribute to the achievement of organizational goals… more
- The Public Schools of Northborough and Southborough (Southborough, MA)
- The Public Schools of Northborough-Southborough School Adjustment Counselor - Lincoln Street Elementary School Therapeutic Learning Program Department: Lincoln ... Street Elementary School Job Title School Adjustment Counselor FLSA Status: (Exempt/Non-exempt) Exempt, Unit A Reports...plans to building staff. Collect and analyze data on risk and protective factors related to student outcomes. Generate… more
- PacificSource (Portland, OR)
- …team member and physician leader at all times. Understand and apply knowledge of risk adjustment and hierarchical condition categories as it relates to clinical ... treatment, and care. Excellent understanding of the insurance industry and risk factors and how they relate to the PacificSource organization. Demonstrated… more
- Navvis (Corvallis, OR)
- …documentation. Monitor key performance indicators related to HCC coding and risk adjustment . Provider Engagement & Collaboration: Facilitate communication and ... models and payment methodologies. Strong understanding of HCC coding guidelines and risk adjustment methodologies. Experience in medical record review and… more
- Genworth Financial, Inc. (Richmond, VA)
- …and support departmental goals. Collaborate with subject matter experts (eg, quality, risk adjustment , utilization management) and support the implementation of ... new workflows, reporting requirements, and process changes. What you bring Bachelor's degree in business administration, or health related degree. 7+ years experience with managing provider network and provider relations. Operational excellence - Proven track… more
- Emcara Health (Clermont, FL)
- …comprehensive home-based primary care solutions, as well as prospective and retrospective risk adjustment programs. Our national value-based medical group is ... and proficiency with electronic medical records. Have a strong understanding of risk adjustment models for the Center for Medicare and Medicaid Services (CMS)… more
- UnitedHealth Group (Columbus, OH)
- …care models Familiarity with Medicare Advantage, SNP regulations, and risk adjustment methodologies Excellent communication, presentation, and strategic ... thinking skills Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …delivery of high-quality, trustable clinical data to support key initiatives around quality, risk adjustment , medicare stars, and interoperability. This is a key ... Collaborate with cross-functional teams, including clinical operations, performance measurement, and risk adjustment , to execute on data procurement & usage… more
- Ur-Energy (Casper, WY)
- …systems, equipment, and components to identify hazards, defects, and the need for adjustment or repair, and to ensure compliance with codes. Advise management on ... or airborne particles; toxic or caustic chemicals; and energized electrical components with risk of electrical shock; and may be required to wear a respirator. There… more
- Amazon (Seattle, WA)
- …innovative solutions? Do you like to innovate and simplify? Our mission in Buyer Risk Prevention (BRP) is to make Amazon.com the safest place to transact online. BRP ... As such, BRP designs and builds the software systems, risk models and operational processes that minimize risk...have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support… more
- Amazon (Bellevue, WA)
- …Claims Management and Operations group is seeking a motivated and experienced Senior Risk Manager. The ideal candidate will be familiar with insurance and claims ... superior written and verbal communication skills. In this role, the Senior Risk Manager will use their expertise in procurement, account management, liability and… more
- Bristol-Myers Squibb Company (New Brunswick, NJ)
- …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 ...in their roles. Applicants can request a reasonable workplace accommodation/ adjustment prior to accepting a job offer. If you… more
- Hueman Risk Adjustment Solutions (Southwest Harbor, ME)
- …actively hiring Nurse Practitioners and Physician Assistants to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and around ... believe that happiness should be a fundamental part of every role in risk assessment. Our opportunities provide flexibility, extra income, and integration into your… more
