- Point32Health (Canton, MA)
- …updates, discuss strategic initiatives and improvement opportunities + Work collaboratively with risk adjustment provider educators and the quality assurance ... enjoy the important work we do every day in service to our members, partners, colleagues and communities. To... provider outreach and ongoing communications/reporting for all risk adjustment programs and initiatives. Serve as… more
- Point32Health (SC)
- …Commercial and Medicaid HCCs through medical record reviews. The Risk Adjustment Coding Specialist II reviews provider documentation of ICD-10-CM (including ... provide analyses and recommendations to improve overall provider documentation and coding. The Risk Adjustment Coding Specialist II will review medical… more
- Somatus (Mclean, VA)
- …provider Network Management and the Quality Program to implement tactics for risk adjustment optimization, particularly for provider and member engagement ... well-being + Community engagement opportunities + And more! The Director, Medicare Risk Adjustment (MRA) will lead the execution strategy and implementation… more
- Baystate Health (Springfield, MA)
- The Prospective Outpatient Risk Adjustment Coder supports risk adjustment optimization activities that improve value-based care and population health by ... record before provider visits and uses ICD-10 CM coding guidelines and risk adjustment model regulations to identify missed opportunities to address chronic… more
- Insight Global (Fort Myers, FL)
- …programs for provider education -Identifying issues and determining impact to risk adjustment models and reports results for various products and services ... service coding . 3+ Experience with Medicare risk adjustment coding and HCC coding (retrospective...prospective experience) . Valid CPC certification . Experience with provider education -Bachelors Degree or associates degree in related… more
- The Cigna Group (Bloomfield, CT)
- …regulations and polices related to documentation and coding. + Knowledgeable of Medicare Risk Adjustment . + Proficiency with ICD-10-CM coding and guidelines. + ... obtained through a cable broadband or fiber optic internet service provider with speeds of at least..._###@cigna.com_ _for an update on your application or to provide your resume as you will not receive a… more
- HSBC (New York, NY)
- …all relevant risk areas eg credit risk , counterparty credit risk , securitization, and Credit Valuation Adjustment ('CVA'). GRPA currently maintains a ... the establishment of interpretations and governance processes to mitigate regulatory risk . GRPA also monitors new rule developments and other ongoing changes… more
- The Cigna Group (Chattanooga, TN)
- …populations in an operational market. The role will be accountable for assigned provider groups reaching risk adjustment related annual metrics. This ... assigned market. Lead Analyst will be primary contact for provider groups on Risk Adjustment ...obtained through a cable broadband or fiber optic internet service provider with speeds of at least… more
- The Cigna Group (Bloomfield, CT)
- …assigned populations in an operational market. The role will be accountable for assigned provider groups reaching risk adjustment and stars related annual ... care. The role will work under the direction of Risk Adjustment & Stars Provider ...obtained through a cable broadband or fiber optic internet service provider with speeds of at least… more
- Healthfirst (NY)
- …key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for- Service ), Diagnosis Related Groups ... State/CMS. + Assist and monitor direct payment initiatives from the state for Provider Organizations + Responsible for contract analysis and fee schedule modeling. +… more
- Humana (Columbus, OH)
- …integral part of a cross-functional, collaborative organization which includes Provider Service Experience, Network Optimization, Clinical Services, Value-Based ... community and help us put health first** The Senior Provider Engagement Professional- Practice Transformation is responsible for driving...contracting, HEDIS and Risk Adjustment . Reporting to the Associate Director… more
- Molina Healthcare (Las Vegas, NV)
- **JOB DESCRIPTION** **Job Summary** Responsible for continuous quality improvements and risk adjustment accuracy for all government lines of business. Supports ... ASO, etc. **Preferred Education:** Master's Degree **Preferred Experience:** + Experience with risk adjustment and quality metrics with government business lines… more
- The Cigna Group (Seattle, WA)
- …on topics including, but not limited to: preventative and quality outcome metrics, risk adjustment , medical cost management, etc. + Schedules, prepares for and ... to Health Services, Medical Economics, Sales, and Sales & Risk Adjustment in order to develop solutions...obtained through a cable broadband or fiber optic internet service provider with speeds of at least… more
- Bloomberg (New York, NY)
- …products and services. Our focus is to address risks and related issues by providing risk management as a service , focusing on providing and delivering value to ... Legal and Compliance, Finance, Operational Resilience and Internal Audit, to provide centralized risk frameworks, processes, tools, training and advisory… more
- Bloomberg (New York, NY)
- …products and services. Our focus is to address risks and related issues by providing risk management as a service , focusing on providing and delivering value to ... Legal and Compliance, Finance, Operational Resilience and Internal Audit, to provide centralized risk frameworks, processes, tools, training and advisory… more
- HCA Healthcare (Campbell, CA)
- …. Minimum 1 year experience with HCC coding and risk adjustment Physician Services Group (https://careers.hcahealthcare.com/pages/physician-services) is skilled ... care like family! Jump-start your career as a(an) HCC Risk Management Specialist today with HCA Healthcare. **Benefits** HCA...3% to 9% of pay (based on years of service ) + Employee Stock Purchase Plan with 10% off… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- Property Claims Manager (State Risk Adjuster 6) Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4534112) Apply Property Claims Manager (State ... Risk Adjuster 6) Salary $4,470.00 - $8,767.00 Monthly Location...verification via the federal government's E-verify system. No Civil Service test score is required in order to be… more
- Henry Ford Health System (Troy, MI)
- …resolution with Claims Processing, Business Configuration Team, Provider Reimbursement, Provider Finance, Risk Adjustment and other departments as ... providers; Provides subject matter expertise for the development and implementation of provider reimbursement, risk sharing and incentive models. + Reviews… more
- PNC (Charlotte, NC)
- …& Model Development Group Manager Senior you will be a member of the Independent Risk Management team reporting to PNC's Chief Model Risk Officer. This position ... an accomplished Senior Validation Manager to lead our Market Risk Model and Counterparty Credit Risk Model...models, such as Potential Future Exposure (PFE), Credit Valuation Adjustment (CVA), and Funding Valuation Adjustment (FVA).… more
- Bloomberg (New York, NY)
- …used. And senior executives will obtain a greater sense of control over their risk through the transparency Bloomberg solutions provide . **What's the role?** As ... Risk & Valuations Sales Specialist (BVAL), Specialist Sales...for our 20,000+ employees across 176 offices globally, we provide the spaces and systems that allow our teams… more