- Tufts Medicine (Burlington, MA)
- …coding meets both established coding standards as well as CMS and Commercial Risk Adjustment guidelines. This position has extensive knowledge of overall ... improve overall provider documentation as it pertains to coding and risk adjustment guidelines. Reviews medical records to determine if diagnostic codes… more
- Corewell Health (Grand Rapids, MI)
- Job Summary As a key leader in the Risk Adjustment team, the successful candidate will develop and execute strategies, programs and projects for both the MA and ... clients/providers. The position also serves as a subject matter expert for the Risk Adjustment team. Essential Functions + Manages the daily workflow of Risk … more
- CVS Health (Northbrook, IL)
- …for an enthusiastic team player to lead local market Medicaid Provider Engagement risk adjustment initiatives across the Aetna Better Health Plans. Reporting to ... the Provider Engagement Lead Director of Medicaid Risk Adjustment Provider Engagement , the Manager will work closely with cross-functional leadership across the… more
- CareOregon (Portland, OR)
- Job Title Risk Adjustment Analytics Manager Exemption Status Exempt Department Finance Manager Title Director, Risk Adjustment Direct Reports Risk ... Summary Responsible for the development, execution, and management of the risk adjustment data analytics programs for the Medicare Advantage and Medicaid… more
- The Cigna Group (UT)
- ** Risk Adjustment Provider Educator** **_Incumbent_** **_candidate must reside in assigned territory and have the ability to travel to the local office and ... to base salary._** This role is responsible for supporting Cigna Medicare Advantage's Risk Adjustment program for assigned populations in an operational market.… more
- LA Care Health Plan (Los Angeles, CA)
- Enterprise Risk Adjustment Analyst III Job Category: Accounting/Finance Department: Risk Adjustment Strategies & Initiatives Location: Los Angeles, CA, ... support the safety net required to achieve that purpose. Job Summary The Enterprise Risk Adjustment Analyst III will provide a key leadership role in the Risk… more
- CVS Health (Hartford, CT)
- …opportunity for an enthusiastic team player to lead a suite of market focused Risk Adjustment Programs for a portfolio of Aetna Better Health Medicaid Plans. ... Reporting to the Senior Manager of Medicaid Risk Adjustment , the Market Manager of Medicaid Risk Adjustment will work closely with cross-functional… more
- Apex Health Solutions (Houston, TX)
- SUMMARY: Risk Adjustment Coder is responsible for reviewing, abstracting, and coding inpatient and/or outpatient medical records to ensure proper ICD-10 coding ... and compliance with risk adjustment requirements. Reports to: AVP, STARs & Risk Adjustment Location: Houston, TX EDUCATION: * High School Diploma or GED… more
- Trinity Health (Syracuse, NY)
- **Employment Type:** Full time **Shift:** **Description:** ** Risk Adjustment Coding Specialist - CNY AIM (CIN), St. Joseph's Health - Full-time - Remote** ... Weekly Hours:** 40 **Shift:** Day Shift **Details:** **POSITION PURPOSE:** The Risk Adjustment Coding Specialist works in a team environment and is responsible… more
- Somatus (Mclean, VA)
- Overview The Director, Medicare Risk Adjustment (MRA) will lead the execution strategy and implementation of the organization's Risk Adjustment Programs ... on an MRA strategy (eg prospective, retrospective, concurrent approaches). + Lead risk adjustment operational programs aimed at monitoring, oversight, and… more
- CVS Health (Jackson, MS)
- …to make health care more personal, convenient and affordable. As the Senior Manager, Risk Adjustment (Medicare) will be responsible for leading Risk ... Mississippi. This role will have responsibility in maintaining and improving risk adjustment accuracy by partnering closely with leadership from our key… more
- CVS Health (Atlanta, GA)
- …to make health care more personal, convenient and affordable. As the Senior Manager, Risk Adjustment (Medicare) will be responsible for leading Risk ... will have specific responsibility for Georgia in maintaining and improving risk adjustment accuracy by partnering closely with leadership from our key provider… more
- Trinity Health (Fort Lauderdale, FL)
- …or perform data mining and data-driven analysis to forecast/evaluate the performance of the risk adjustment program and refine annual risk adjustment ... program strategies to achieve optimal performance. Incorporate data-driven analysis into the risk adjustment processes. + Develop and monitor metrics of program… more
- Molina Healthcare (Long Beach, CA)
- …+ Provides training and education to network of providers on how to improve their risk adjustment knowledge as well as provide coding updates related to Risk ... in related field **Preferred Experience** + Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model + Background in supporting risk … more
- Martin's Point Health Care (Portland, ME)
- …a "Great Place to Work" since 2015. Position Summary The Senior Director of Risk Adjustment Operations in our Health Plan is responsible the overall development, ... refinement, maintenance, monitoring and oversight of Medicare Risk Adjustment initiatives and operations. The Senior Director is also responsible for all aspects… more
- Martin's Point Health Care (Portland, ME)
- …offers a remote work schedule and 2-4 visits to Maine, per year! Join this dynamic Risk Adjustment Team in our Health Plan which is growing and making an impact! ... Apply today for immediate consideration! The Senior Risk Adjustment Analyst in our Health Plan analyzes data, reviews findings, and develops recommendations for… more
- Point32Health (Canton, MA)
- …this individual will be responsible for supporting critical data submission functions for the Risk Adjustment Department (RAD) including risk adjustment ... and timely resolution of production issues pertaining to CMS and risk adjustment data submission, including issue investigation, business requirements,… more
- Molina Healthcare (Topeka, KS)
- …Description** **Work Location - Kansas** **Job Summary** The AVP, Quality Improvement & Risk Adjustment is responsible for leading health plan execution for ... Risk Adjustment and Quality for all lines...Risk Adjustment and Quality for all lines of business, ensuring...of strategy and activities with Enterprise, acting as the Risk Adjustment and Quality subject matter expert… more
- ChenMed (Miami, FL)
- …We're rapidly expanding and we need great people to join our team. The Risk Adjustment Coder works in a collaborative effort directly with physicians and ... to review medical records and other clinical documentation to identify appropriate risk adjustment codes and quality gap closure opportunities. A major… more
- BlueCross BlueShield of North Carolina (NC)
- …facing role. Evaluates and monitors provider performance to achieve excellence in risk adjustment coding. Participates in regular provider meetings and/or calls ... Do** + Coordinates and leads Provider facing meetings to achieve excellence in risk adjustment coding. + Collaborates with Risk Data Analytics and Value… more
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