- Emanate Health (Covina, CA)
- …MSO personnel on HCC and STAR measures related tasks. Responsible to ensure the IPA risk adjustment factor maintains or exceeds 1.0 and achieves or improves upon ... Responsible for the oversight of HCC Program and STAR measures coding related functions. The coding specialist will work with the IPA Director , Health… more
- Ankura (New York, NY)
- …Risk Adjustment data collection and submission activities as well as knowledge of Risk Adjustment coding requirements preferably with a Risk ... and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment . The Senior Director will also support practice… more
- Point32Health (Canton, MA)
- …with our corporate and business division goals. This position will report to the Director of Risk Adjustment Strategy, Operations and Quality Assurance. ... Point32Health (https://www.point32health.org/) . **Job Summary** This position will lead the Risk Adjustment Operations & Provider Consulting team responsible… more
- CenterWell (Tallahassee, FL)
- … leaders/coders) + Partner with MRA Strategy and Analytics teams to establish risk adjustment analytics to identify coding improvement opportunities, ... caring community and help us put health first** The Director , Medical Coding extracts clinical information from...function or segment. **Strategy:** + In partnership with AVP, Risk Adjustment and AVP, MRA Strategy, responsible… more
- Mount Sinai Health System (New York, NY)
- … coding operations in a multi-entity or academic health system. - Familiarity with risk adjustment , HCC coding , and value-based care models. - Proven ... **Job Description** The Senior Director of Coding is a strategic and operational leader responsible for overseeing all aspects of professional and hospital … more
- Henry Ford Health System (Detroit, MI)
- …to maximize accurate reimbursement. + Support initiatives for quality reporting, risk adjustment , provider education, and regulatory compliance. Innovation, ... and ensuring the financial strength of our system. As the Director of Procedural and Anesthesia Coding , you'll set the strategy and lead system-wide efforts to… more
- St. Mary's Healthcare (Amsterdam, NY)
- …Demonstrated knowledge of ICD-10-CM/PCS, CPT/HCPCS coding , MS-DRGs, APR-DRGs, APCs, and risk adjustment . Certifications / Licensure: + RHIA, RHIT, or CCS ... factors permitted by law. Responsibilities: + Provide day-to-day leadership to coding teams across inpatient, outpatient and professional services. + Partner with… more
- Humana (Salt Lake City, UT)
- …make an impact** **Required Qualifications** + 5+ years of experience in risk adjustment coding /auditing/education and provider relations/engagement + ... gained from actual experience of chronic condition documentation and coding audits, risk adjustment program...+ Cultivate effective partnerships in a matrix environment of coding educators, medical director , clinical and market… more
- Datavant (Topeka, KS)
- …and prospects. + Serve as a trusted advisor, demonstrating a strong understanding of risk adjustment , HCC coding , and value-based care operations. + Liaison ... **What We're Looking For** We are seeking an experienced Director of Risk Bearing Provider Sales to...in complex healthcare environments. + Deep understanding of **HCC coding , chart retrieval, risk adjustment … more
- Catholic Health Initiatives (Little Rock, AR)
- … for the value hub. + Through Risk Management/Auditor Manager, implements a risk adjustment coding department in appropriate Arkansas and Kentucky CIN. + ... CIN/Population Health Management experience required + Must have experience with risk adjustment coding and value based reimbursement models of payment… more
- HCA Healthcare (Fort Lauderdale, FL)
- … coding and documentation improvement education to Providers. + Assists the Director Coding Operations Division Support in reviewing progress against business ... Coder (CPC(R)) credential or Certified Professional Coder - Hospital (CPC-H(R)) or Certified Risk Adjustment Coder (CRC) EXPERIENCE: + Experience with Cerner and… more
- Molina Healthcare (MI)
- …Description** **Job Summary** The Director , Clinical Data Acquisition for Risk Adjustment , is responsible for the implementation, monitoring, and oversight ... of all chart collection for Risk Adjustment , RADV, or ...audit projects and deliverables related to accurate billing and coding . This role also works with the Health Plan… more
- Scripps Health (San Diego, CA)
- …of ICD, CPT, and HCPCS coding systems, MS-DRG/APR-DRG methodologies, and risk adjustment /HCC principles. * Strong technical proficiency and experience in ... *This Senior Director position is eligible to participate in the...Documentation Integrity*provides strategic leadership and operational oversight for systemwide Coding , Clinical Documentation Integrity (CDI), and Health Information Management… more
- Beth Israel Lahey Health (Charlestown, MA)
- …a strong understanding of case mix index, MCC/CC capture, the severity of illness/ risk of mortality, LOS, risk adjustment diagnoses. * Participate ... the Beth Israel Lahey Health (BILH) Vice President, Mid-Revenue Cycle, the Director of Clinical Document Improvement (CDI) is primarily responsible for managing all… more
- Bristol Myers Squibb (Princeton, NJ)
- …resilience from a Business Continuity Management (BCM), Crisis Response, and proactive risk identification and mitigation perspective. This role will support the BCM ... and tools, including those that drive our BCM planning and proactive risk management capabilities. **Roles and Responsibilities:** + Drive partnership with business… more
- Amazon (Mountain View, CA)
- …with business teams on science-heavy problems, incubating products with high AI research risk , reducing friction and manual effort with AI tooling, and raising the ... Mathematics). - Experience in industry, consulting, government, or academic research. - Coding ability in a scripting language such as R, Python, Matlab, or… more
- Hartford HealthCare (Farmington, CT)
- …observed to expected ratio (O:E), capture of appropriate severity of illness (SOI) and risk of mortality (ROM), risk adjustment and hierarchal condition ... work in collaboration with the clinical documentation specialists (CDS), coding professionals, providers, nursing staff and other patient care...capture (HCC) codes, risk adjustment , and other high quality documentation outcome measures. .… more
- Good Samaritan (Sioux Falls, SD)
- …and knowledge of accreditation and regulatory agency standards preferred. Quality, medical coding , and/or risk adjustment experience is preferred. Currently ... of the assigned area(s) of nursing. Will incorporate responsibilities related to the quality risk and risk score adjustment programs. Assist with the quality… more
- Point32Health (RI)
- …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 ... . **Job Summary** Working under the direction of the Director or Senior Manager, the Senior Network Performance Analyst...and Reserving to ensure open communication relating to provider risk deals. + In-depth knowledge and understanding of managed… more
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