- CITY OF TURLOCK (Turlock, CA)
- …community. City Manager's Office City Attorney's Office Human Relations Risk Management Finance Economic Development Development Services Municipal Services Police ... an applicant receive more than a five (5) point adjustment . This request should be made in section #12...participate in Social Security; however, it does participate in Medicare and the employee portion is 1.45%. Deferred Compensation:… more
- 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 ... ensure the appropriate ICD10 and CPT codes submitted for Medicare and Covered CA lines of business. Coding specialist...Must have at least one year of experience in Medicare HCC program within IPA, HMO, or clinic setting.… more
- BlueCross BlueShield of North Carolina (NC)
- …at least 9 years of relevant actuarial experience. **Bonus Points** + Experience in Medicare Advantage Risk Adjustment highly preferred **What You'll Get** + ... The opportunity to work at the cutting edge of health care delivery with a team that's deeply invested in the community. + Work-life balance, flexibility, and the autonomy to do great work. + Medical, dental, and vision coverage along with numerous health and… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Medicare Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and ... integrity of key risk adjustment performance metrics through coordination of analytical processes, investigation and interpretation of CMS risk score… more
- Baylor Scott & White Health (Austin, TX)
- + **JOB SUMMARY** The Risk Adjustment Analyst Sr is responsible for monitoring and oversight of the end-to-end encounter management workflow. This position ... to provide insight to decision-makers. This role supports program management activities around risk adjustment data management and submissions to CMS. This role… more
- Elevance Health (Mason, OH)
- ** Risk Adjustment Process Expert I** **Location:** Louisville, KY **Hybrid 1:** This role requires associates to be in-office 1 - 2 days per week, fostering ... an accommodation is granted as required by law. The ** Risk Adjustment Process Expert** is responsible for...adjustment experience strongly preferred. + 3 years of Medicare /Medicaid experience is strongly preferred. + Strong oral, written… more
- Redeemer Health Home Care & Hospice (Huntingdon Valley, PA)
- …Graduate. Certified coder CPC or CCS-P, and AAPC CRC certification. 2+ years coding, Medicare Risk Adjustment / Medicare Advantage and/or clinical. Plans ... and supporting clinical care plans to Risk Adjustment Data Validation (RADV) Timelines. Medicare and...Risk Adjustment Data Validation (RADV) Timelines. Medicare and Medicaid regulations and billing guidelines and AMA's… more
- Ankura (New York, NY)
- …master's degree from an accredited college/university + 8+ years of experience in Medicare Risk Adjustment operations, internal audit, or compliance either ... compliance, accreditations, operations, investigations, and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment . The… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …and military experience will be considered. * Experience in medical coding with a focus on Medicare Advantage and ACA risk adjustment . * Certified Risk ... Coder (CRC) certification * In-depth knowledge of ACA & Medicare Advantage risk adjustment methodology, coding guidelines (ICD-10-CM), healthcare compliance,… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …company seeks a highly skilled and results-driven Senior Product Manager to lead our Medicare Advantage Risk Adjustment solution portfolio. In this critical ... will drive the strategic planning, development, and optimization of our Medicare Advantage Risk Adjustment solution, ensuring that our deliverables support… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …and vendor performance relative to established contracts. * Collaborate with actuarial, finance, Medicare and risk adjustment to ensure all inputs and ... Have We are looking for an Actuary for our Medicare Provider Relations team! You will apply broad actuarial...Works closely with actuarial, finance, data & analytics, stars, risk adjustment , and other lever owners to… more
- Health Care Service Corporation (Chicago, IL)
- …key performance indicators, trends, and financial acumen + Knowledge of Medicare Stars, Medicare Risk Adjustment , and Medicare Finance. + Strong ... the team to support divisional short and long-term initiatives related to Medicare provider network strategy and leverage analytics to drive provider network… more
- Humana (Newnan, GA)
- …exceptional follow up skills + Valid Driver's license and reliable transportation + Medicare Risk Adjustment knowledge **Additional Information** Work at ... leadership, webinars public speaking and/or presentation skills with healthcare providers + Risk Adjustment knowledge + Familiar with coding guidelines + Live… more
- Humana (Helena, MT)
- …business outcomes. + Lead financial analytics projects, with a focus on outcomes of Medicare risk adjustment operations and initiatives. + Work independently ... actionable insights for non-technical stakeholders. **Preferred Qualifications** + Experience with Medicare Risk Adjustment programs and/or CMS datasets.… more
- Humana (Columbia, SC)
- …Finance, Health Care/Administration, RN or a related field + Experience with Medicare Risk Adjustment + Progressive experience with interoperability ... advance their goals related to interoperability, quality, value-based arrangements, and risk adjustment strategies + Recommends execution strategies and monitor… more
- Humana (Baton Rouge, LA)
- …or BSN (unrestricted compact license), or equivalent healthcare experience + Experience with Medicare Risk Adjustment and/or medical coding + Progressive ... advance their goals related to interoperability, quality, value-based arrangements, and risk adjustment strategies. Recommend execution strategies and monitor… more
- Humana (Richmond, VA)
- …Finance, Health Care/Administration, RN or a related field + Experience with Medicare Risk Adjustment + Progressive experience with interoperability ... advance their goals related to interoperability, quality, value-based arrangements, and risk adjustment strategies + Recommends execution strategies and monitor… more
- Humana (Denver, CO)
- …leaders and their respective functions with a focus on Provider Engagement, Quality and Medicare Risk Adjustment . The RVP, Network Performance represents the ... is responsible for the overall success of Stars and Risk Adjustment strategy and performance within a...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- Blue KC (Kansas City, MO)
- …analysis and forecasting of that data. **Job Description** + Maintains expert knowledge of Medicare Advantage & ACA Risk Adjustment models + Responsible for ... the functions of the role + Minimum 5 years' experience in Medicare Advantage & ACA Risk Adjustment submission experience **Blue Cross and Blue Shield of… more
- Point32Health (Canton, MA)
- …will oversee all provider engagement and reporting activities for risk adjustment programs and initiatives that impact Medicare , Medicaid, and Duals product ... Point32Health (https://www.point32health.org/) . **Job Summary** This position will lead the Risk Adjustment Operations & Provider Consulting team responsible… more
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