- Martin's Point Health Care (Portland, ME)
- …has been certified as a "Great Place to Work" since 2015. Position Summary The Risk Adjustment Analyst provides analytic, technical, and decision support to ... timely, and consistent information enabling informed decisions related to risk adjustment activities. The Analyst ...of third-party analytical tools and reporting platforms related to risk profile analysis and HCC coding +… more
- Commonwealth Care Alliance (Boston, MA)
- …in other states will not be considered at this time._** Position Summary: The Risk Adjustment Business Analyst is responsible for understanding and ... methodology, and will play an essential role in driving Risk Adjustment (RA) Program performance. Supervision Exercised:...processes for all essential Health Plan risk adjustment program activities including identifying gaps in coding… more
- Centene Corporation (Tallahassee, FL)
- … risk adjustment and/or compliance required + Previous experience in risk adjustment oversight and/or coding planning preferred + Demonstrated ... from home anywhere in the Continental United States.** **Position Purpose:** Supports the Risk Adjustment Compliance program elements, with a focus on the… more
- UCLA Health (Los Angeles, CA)
- …and others. + Serve as a key departmental resource for application use related to risk adjustment coding guidelines and gap closure reporting. Salary Range: ... As the Business Data Analyst for our Medicare Advantage Risk Adjustment team, you will be responsible for producing accurate and insightful department… more
- Corewell Health (Grand Rapids, MI)
- …Some states are not eligible for remote work (CA and NY). Positioned in the Risk Adjustment Department, the Manager, Risk Adjustment Analytics will ... be responsible for leading the Risk Adjustment Analytics team and supporting the goals and objectives...who is adept at problem solving, possesses strong SQL coding skills and an ability to communicate effectively to… more
- The Cigna Group (Bloomfield, CT)
- Job Summary: The Risk Adjustment Quality & Review Analyst in IFP brings medical coding and Hierarchical Condition Category expertise to the role, ... members and matrix partners to facilitate various aspects of coding and Risk Adjustment education...needed. Education & Experience: The Quality Review & Audit Analyst will have a high school diploma and **at… more
- The Cigna Group (Bloomfield, CT)
- …goals. The Quality Review and Audit Senior Analyst position recognizes experience in Risk Adjustment Data Validation audits (RADV), Risk Adjustment ... Risk Adjustment medical record and diagnosis coding excellence, implementation of Quality Improvement processes, and the...to remain current on Federal regulations related to diagnosis coding and the HHS Risk Adjustment… more
- MedKoder (Mandeville, LA)
- … coding veteran, the company offers services including inpatient and outpatient facility coding , medical risk adjustment management, DRG coding ... About Us MedKoder, LLC is a full-service medical coding management services provider based in Mandeville, Louisiana, specializing in expert medical coding for… more
- Providence (Anaheim, CA)
- …medical group practice management. + Experience in physician compensation, billing, capitation, risk adjustment , CPT coding , and resource-based relative ... direction of the Manager, Physician Compensation, the Physician Compensation Analyst manipulates data, completes analyses, calculates physician performance relative… more
- Point32Health (Canton, MA)
- …claims data, coding schemes (ICD-9/ICD-10, CPT/HCPCS, DRGs), and health status risk adjustment . In-depth health care reimbursement and managed care business ... direction of the Director or Senior Manager, the Senior Analyst will be part of a team responsible for...ad hoc requests. The Senior Network & Provider Analytics Analyst may also serve as a project manager and/or… more
- Molina Healthcare (Columbus, OH)
- …of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key… more
- AdventHealth (Burleson, TX)
- …understanding of hospital readmission metrics, especially CMS. Working knowledge of ICD-10 coding , risk adjustment , and clinical documentation improvement. ... low-cost of living. **The role you'll contribute:** The Quality Improvement Analyst obtains and analyzes clinical data to identify process improvement opportunities,… more
- New York State Civil Service (Albany, NY)
- …Services, Department of Title Virtual Currency Data Governance Senior Analyst (Financial Services Specialist 2 (Policy Analysis), SG-23) Occupational Category ... otherwise add value to the team;* Ensures consistency by adhering to software coding and style guides;* Provides training and support to dashboard users and ensures… more
- Centene Corporation (Jefferson City, MO)
- …preferred. Familiarity with claims payment, utilization management, provider/vendor contracts, risk adjustment for government sponsored healthcare desired. Pay ... preferred. Working knowledge of SQL/query languages. Preferred knowledge of programmatic coding languages such as Python and R. Knowledge of statistical, analytical,… more
- Centene Corporation (Jefferson City, MO)
- …preferred. Familiarity with claims payment, utilization management, provider/vendor contracts, risk adjustment for government sponsored healthcare desired. Pay ... preferred. Working knowledge of SQL/querying languages. Preferred knowledge of programmatic coding languages such as Python and R. Knowledge of statistical,… more
- AmeriHealth Caritas (Newtown Square, PA)
- …teams on Quality analytics and supplemental data opportunities. + Deep knowledge of HCC Coding , risk adjustment models (CMS, HHS,STARS, HEDIS, and value ... Senior Vice President, the Vice President, HEDIS / Stars Risk Adjustment Performance Strategy serves as the...quality performance, with oversight of strategies that impact HCC coding accuracy, risk score integrity, and quality… more
- AdventHealth (Altamonte Springs, FL)
- …manage multiple priorities at once with little supervision. Possesses knowledge about risk adjustment and hospital publicly reported data. Possesses knowledge ... goals. Employee will assist in training other team members on inpatient coding . The Coder Analyst IV may participate in our quality, safety review process, which… more
- Amazon (Sunnyvale, CA)
- …that provides customers with control and transparency and reducing privacy risk , while enabling partner teams to innovate with appropriate guardrails for ... and tooling. Key job responsibilities * Manage escalated privacy and trust risk events/cases from start to finish; write detailed case notes, reports, summaries,… more
- Point32Health (VT)
- …claims data, coding schemes (ICD-9/ICD-10, CPT/HCPCS, DRGs), and health status risk adjustment . In-depth health care reimbursement and managed care business ... the Director or Senior Manager, the Senior Network Performance Analyst will be part of a team responsible for...and Reserving to ensure open communication relating to provider risk deals. + In-depth knowledge and understanding of managed… more
- Amazon (Arlington, VA)
- …data to search for evidence of potentially damaging threat activities which pose a risk to Amazon customers and data. - You will work alongside incident responders ... team. - Work alongside other engineers to improve security and reduce operating risk for our customers. - Monitor cybersecurity media, blog posts, and other sources… more