- Molina Healthcare (Ridgeland, MS)
- **Job Description** **Job Summary** The AVP , Quality & Risk Adjustment is responsible for leading health plan execution for Risk Adjustment and ... of strategy and activities with Enterprise, acting as the Risk Adjustment and Quality subject... subject matter expert for the health plan. The AVP leads a plan with a large membership base,… more
- Molina Healthcare (San Jose, CA)
- … & quality improvement in collaboration with the Plan President, AVP of Quality & Risk Adjustment , and Network team. + Leads team of Practice ... Collaborates with Health Plan Network to drive value-based care strategy related to risk adjustment & quality . + Sets Health Plan level performance goals and… more
- Molina Healthcare (Cleveland, OH)
- …Summary** **Job Summary** The AVP , Clinical Data Acquisition is a key Risk Adjustment (QI) leader within the organization enterprise wide. This position ... adjustment and project set-up/implementation * Manages state Risk / Quality leader relationships and RA related collection... Quality (CPHQ) * Nursing License * Certified Risk Adjustment Coding (CRC) To all current… more
- Travelers Insurance Company (Salem, OR)
- …complex claims, in multiple jurisdictions, in accordance with Best Practices. Provide quality claim handling and superior customer service on assigned claims, while ... file exposure is greater than $2 million. + Provide quality customer service and ensure file quality ...activities required to effectively evaluate claims, such as Subro, Risk Control, nurse consultants and fire or fraud investigators… more
- CenterWell (Tallahassee, FL)
- …organization capabilities interrelate across the function or segment. **Strategy:** + In partnership with AVP , Risk Adjustment and AVP , MRA Strategy, ... (including GenAI) + Responsible for performance management and strategy development for PCO risk adjustment at the division and market level; Partners with… more
- Citigroup (Getzville, NY)
- …of driving data strategy and ensuring the highest standards of data quality and governance. **Team Overview: Regulatory and Analytics (R&A)** The Regulatory and ... across various business and technology units to implement robust data quality management policies and procedures, and to provide subject matter expertise… more