- CareFirst (Baltimore, MD)
- … across the organization within Medicare Advantage, Medicaid & ACA markets. The Risk Adjustment Director is responsible for strategic direction, leadership, ... **Resp & Qualifications** **PURPOSE:** The Director , Risk Adjustment oversees...as an SME to guide CareFirst's VP of Enterprise Quality & Risk Adjustment , Finance,… more
- Blue KC (Kansas City, MO)
- …with adoption financial assistance** **Employee discount program** **Job Description Summary:** The Director , Government Programs Risk Adjustment & Audit ... risk adjusted revenue optimization strategy and oversight of Government Programs Risk Adjustment programs. **Job Description** + Interface with Blue KC… more
- Datavant (Little Rock, AR)
- …to realize our bold vision for healthcare. **What we're looking for:** The incoming Risk Adjustment Analytics Manager will be stepping into a role on the ... manager will collaborate with other managers and the department director to set strategy and mobilize the team to...and management of workloads, communication with stakeholders, and the risk adjustment subject matter expertise necessary to… more
- Dignity Health (Bakersfield, CA)
- …ensure maximum reimbursement from health plan payors. The role reports directly to the Risk Adjustment Population Health Director and plays a critical role ... **Responsibilities** This position is remote.** **Position Summary:** The Risk Adjustment Coding Training Specialist develops and executes comprehensive training… more
- Bristol Myers Squibb (Princeton, NJ)
- …critical to quality (CtQ) data, processes, and vendors, demonstrating effective risk and issue management. Provide quality and compliance consultation to ... at a study and/or ASSET and TA level, to document the end-to-end risk -based quality management for CtQ data, processes and vendors demonstrating effective… 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 ... practices and (2) close partnership with the CDQI Director to drive accurate risk adjustment...hardwiring processes to drive excellence in efficiency of care, quality and accurate risk adjustment … more
- Bristol Myers Squibb (Seattle, WA)
- …personal lives. Read more: careers.bms.com/working-with-us . **Position Summary** The Executive Director , Cell Therapy Global Product Quality (CTGPQ) is ... Reviews, Product Life Cycle initiatives, Product Robustness Plans, and Product Risk Registers. Additionally, the Quality Product Leads are accountable for… more
- Bristol Myers Squibb (Indianapolis, IN)
- …The Associate Director of Chemistry, Manufacturing & Controls (CMC) - Quality Assurance develops and drives Quality (manufacturing and analytical) strategies ... be assigned. + Member of CMC Development Teams providing Quality (QA) input from pre-clinical to end of product...+ Work with CMC Teams to conduct compound/product specific risk assessments, as required, for all aspects of the… more
- Amazon (Tempe, AZ)
- …About the Role: We are seeking an experienced professional to join our Risk Mitigation, Escalations Reduction, and Quality Assurance (REs-Q) organization as a ... brands worldwide. The role represents a unique opportunity to shape risk management practices while protecting Amazon's marketplace integrity through data-driven… more
- Bristol Myers Squibb (Princeton, NJ)
- …Controls Function (BCF) is a key contributor to the Company's overall enterprise risk management strategy. The BCF is a global organization with resources based ... in Princeton, NJ. The BCF is a second line risk management function (in accordance with the Institute of...leads and senior management throughout the Company. The Associate Director , US Commercial & OTC Process Control Advisor within… more
- ZoomCare (Portland, OR)
- …initiatives. + Strong understanding of healthcare systems, value-based care models, and risk adjustment . + Proven track record of driving change, improving ... + Train and support clinical teams on proper coding techniques to optimize risk - adjustment and reimbursement. + Analyze coding trends and identify opportunities… more
- Bristol Myers Squibb (Princeton, NJ)
- …Squibb (BMS) is seeking an exceptional leader for the position of Executive Director , Business Insights and Technology (BI&T) Procurement. This role is a unique ... mission is to maximize contract value while maintaining the highest quality standards through clear specifications and well-planned negotiations. The team… more
- CenterWell (Des Moines, IA)
- …entities within the Primary Care Organization. **Strategy:** + In partnership with AVP, Risk Adjustment and AVP, MRA Strategy, responsible for driving ongoing ... (APD) tool) + Responsible for performance management and strategy development for PCO risk adjustment at the division and market level; Partners with Clinical… more
- WelbeHealth (Los Angeles, CA)
- …and financial analysis. This role will focus on overseeing capitation rates, risk adjustment methodologies, claims forecasting, and Incurred But Not Reported ... Python, R), Excel, and financial modeling tools + Deep understanding of CMS risk adjustment , Medicaid rate-setting, and Medicare Advantage/Part D payment models… more
- Bristol Myers Squibb (San Diego, CA)
- …RayzeBio aims to be the global leader in radiopharmaceuticals . The Executive Director , Head of Pharmacovigilance - Safety Science, is responsible for overseeing all ... of safety science to protect patient health and optimize product benefit- risk profiles. The ED works cross-functionally with clinical, regulatory, medical affairs,… more
- Scripps Health (San Diego, CA)
- …Categories (HCCs) for accuracy and compliance as relates to Outpatient CDI. Monitors Risk Adjustment Factor (RAF) Scores. * Directs instructions and education ... This Senior Director position is eligible to participate in the...career. * Our specialties have been nationally recognized for quality in areas such as cardiovascular care, oncology, orthopedics,… more
- CenterWell (Jacksonville, FL)
- …(clinical, financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and clinical ... of our caring community and help us put health first** The Associate Medical Director (AMD) is an instrumental clinical leader of our primary care team, combining… more
- CenterWell (Daytona Beach, FL)
- …(clinical, financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and clinical ... and help us put health first** Job Description Summary The Associate Medical Director (AMD) is an instrumental clinical leader of our primary care team, combining… more
- Molina Healthcare (Racine, WI)
- …regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, Medicaid, NCQA… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …of high- quality , trustable clinical data to support key initiatives around quality , risk adjustment , medicare stars, and interoperability. This is ... true colors to blue. What we need The Associate Director of Clinical Data Management will be a key...with cross-functional teams, including clinical operations, performance measurement, and risk adjustment , to execute on data procurement… more
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