- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- Ready to help us transform healthcare? Bring your true colors to blue. The Medicare Risk Adjustment Strategy Program Manager will report to the Senior ... Director of Medicare Risk Adjustment and Analytics. This role will manage the process of developing and maintaining the risk adjustment strategic… more
- UnitedHealth Group (Eden Prairie, MN)
- …improve data pipeline efficiency and reporting accuracy Conducting ad hoc analyses related to Medicare Risk Adjustment using SQL (SQL Server, Snowflake) and ... part of the Optum Care National Risk Adjustment Healthcare Economics team , we support Medicare...someone with strong SQL skills, a solid understanding of Medicare Advantage Risk Adjustment , and… more
- UnitedHealth Group (Eden Prairie, MN)
- …revenue assessment, predictive suspecting, program evaluations, and strategic guidance related to Medicare Advantage Risk Adjustment . The role also requires ... Caring. Connecting. Growing together. As the Optum Care National Risk Adjustment Healthcare Economics Team, we support...adjustment efforts across our enterprise, primarily focused on Medicare Advantage Risk Modeling. We are internal… more
- HealthCare Partners (Garden City, NY)
- …working in close partnership with the Customer Engagement Center (CEC), Pharmacy, Risk Adjustment , Utilization Management, Quality, Network Relations, and other ... delivering services to our 125,000 members enrolled in Commercial, Medicare and Medicaid products. Our MSO employs 200+ skilled...to ensure accurate understanding and achievement of quality and risk adjustment metrics. Serves as a quality… more
- New directions (Palm Beach Gardens, FL)
- …proficiency with electronic medical records. Have a strong understanding of risk adjustment models for the Center for Medicare and Medicaid Services (CMS) ... comprehensive home-based primary care solutions, as well as prospective and retrospective risk adjustment programs. Our national value-based medical group is… more
- CVS Health (Philadelphia, PA)
- …will provide assessments, advocacy, and comprehensive care coordination services to our highest- risk patients and their caregivers to help them improve their health ... and families surrounding life stage and disease-specific issues, including dementia, adjustment to illness, aging, caregiver support, etc. Meet with care teams… more
- St. Luke's University Health Network (Quakertown, PA)
- …patient as healthy as possible in the outpatient setting, minimizing the risk of readmissions. Issues applicable state/federal regulatory notices as applicable ie.) ... Important Message from Medicare (IMM), Medicare Outpatient Observation Notice (MOON),...Notice (MOON), Bundle Payment Care Initiative (BPCI) notification. Monitors risk assessment using available tools and implements discharge interventions… more
- Memorial Healthcare System (Hollywood, FL)
- …Professional Coder, HCC - Hierarchical Condition Category Coder, CRC - Certified Risk Adjustment Coder, or CPMA Certified Professional Medical Auditor.Additional ... Certified Professional Coder, HCC - Hierarchical Condition Category Coder, CRC Certified Risk Adjustment Coder, or CPMA Certified Professional Medical Auditor.… more
- CVS Health (Allentown, PA)
- …will provide assessments, advocacy, and comprehensive care coordination services to our highest- risk patients and their caregivers to help them improve their health ... and families surrounding life stage and disease-specific issues, including dementia, adjustment to illness, aging, caregiver support, etc. Meet with care teams… more
- Second Wave Delivery Systems, LLC (New York, NY)
- …delivering business analytics and reporting projects; Deep knowledge of risk adjustment models and calculations for Medicare Advantage and Affordable Care ... Act strongly preferred Strong executive-level client facing skills and the ability to communicate complex analytical concepts with confidence to a non-technical executive audience Experience with strategic planning using quantitative techniques Experience… more
- CVS Health (Norristown, PA)
- …will provide assessments, advocacy, and comprehensive care coordination services to our highest- risk patients and their caregivers to help them improve their health ... and families surrounding life stage and disease-specific issues, including dementia, adjustment to illness, aging, caregiver support, etc. Meet with care teams… more
- Everlywell (Austin, TX)
- …with a strong understanding of HIPAA, CMS regulations, value-based care models, risk adjustment , and population health management strategies specific to ... Medicare Advantage, Dual Eligible, and Medicaid populations. Experience with agile development methodologies and tools (Jira, Confluence, etc.). Experience leveraging AI tools and technologies to enhance product development efficiency, with demonstrated… more
- CVS Health (Indianapolis, IN)
- …will provide assessments, advocacy, and comprehensive care coordination services to our highest- risk patients and their caregivers to help them improve their health ... and families surrounding life stage and disease-specific issues, including dementia, adjustment to illness, aging, caregiver support, etc. Meet with care teams… more
- Hueman Risk Adjustment Solutions (Utica, NY)
- …is actively hiring Nurse Practitioners and Physician Assistants to complete in-home Health Risk Assessments (HRAs) for Medicare and Medicaid members in and ... believe that happiness should be a fundamental part of every role in risk assessment. Our opportunities provide flexibility, extra income, and integration into your… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- Ready to help us transform healthcare? Bring your true colors to blue. The Medicare Risk Adjustment Strategy Program Manager will report to the Senior ... Director of Medicare Risk Adjustment and Analytics. This role will manage the process of developing and maintaining the risk adjustment strategic… more
- Elevance Health (Woodbridge, NJ)
- ** Medicare Risk Adjustment Advanced Analytics Analyst** **On-Site Requirement: Hybrid 1;** **This role requires associates to be in-office 1 - 2 days per ... employment, unless an accommodation is granted as required by law._ The ** Medicare Risk Adjustment Advanced Analytics Analyst** is responsible for employing… more
- Elevance Health (Louisville, KY)
- ** Medicare Risk Adjustment Advanced Analytics Consultant** **On-Site Requirement: Hybrid 1;** **This role requires associates to be in-office 1 - 2 days per ... unless an accommodation is granted as required by law._ The ** Medicare Risk Adjustment Advanced Analytics Consultant** is responsible for employing… more
- Molina Healthcare (Des Moines, IA)
- **JOB DESCRIPTION** **Job Summary** Responsible for Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and ... analyze impact. **KNOWLEDGE/SKILLS/ABILITIES** + Collaborate with Actuarial staff to calculate risk adjustment payment estimates. Document assumptions. + Analyze… more
- UCLA Health (Los Angeles, CA)
- Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment , you will be an expert in risk adjustment coding ... and documentation, working closely with physicians, IPA coders, and risk adjustment teams associated with the health plan. You will: + Conduct medical record… more
- UCLA Health (Los Angeles, CA)
- Description As the Business Data Analyst for our Medicare Advantage Risk Adjustment team, you will be responsible for producing accurate and insightful ... Serve as a key departmental resource for application use related to risk adjustment coding guidelines and gap closure reporting. Salary Range: $76,200 -… more
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