- Elevance Health (Atlanta, GA)
- …presentation, and problem-solving, critical thinking skills strongly preferred. + Healthcare business knowledge related to Risk Adjustment Payment ... to the development and implementation of strategic initiatives aimed at improving risk adjustment outcomes. + Monitor the effectiveness of implemented solutions… more
- Datavant (Atlanta, GA)
- … adjustment charts + Understanding of Medicare , Commercial and Medicaid risk adjustment business logic and coding + Knowledge and understanding of ... Ciox core values to all members of Ciox team + Expertise and understanding of risk adjustment business logic + Ability to analyze data to determine the root… more
- Elevance Health (Atlanta, GA)
- …+ Working knowledge of Medicare is strongly preferred + Healthcare business knowledge related to Risk Adjustment Payment Methodology strongly ... effectively consult and guide internal stakeholders on effective use and interpretation of risk adjustment data and KPIs + Provides expertise to lower-level… more
- Humana (Atlanta, GA)
- …+ Demonstrating an understanding of departmental and organizational goals and how risk adjustment compliance supports boarder business priorities. Making ... caring community and help us put health first** The Risk Adjustment Compliance Professional 2 supports the...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- Humana (Atlanta, GA)
- …community and help us put health first** The Director, Risk Adjustment Strategy Advancement will provide business intelligence and strategic planning support ... segments and the company at large. The Director, Risk Adjustment Strategy Advancement requires an in-depth...for a seasoned leader to lead strategic planning and business management for the team. The primary objective of… more
- CenterWell (Atlanta, GA)
- …+ Ability to travel up to 20% **Preferred Qualifications** + Proven experience with Medicare Advantage risk adjustment functions. + Proven track record of ... entities within the Primary Care Organization. **Strategy:** + In partnership with AVP, Risk Adjustment and AVP, MRA Strategy, responsible for driving ongoing… more
- Humana (Atlanta, GA)
- …factors. This position utilizes financial projection and analytics skills while working in Medicare risk adjustment . Additionally, you will work to build ... Qualifications** + Experience working with Medical Claims or other healthcare data + Medicare Risk Adjustment Experience + Financial or actuarial background… more
- CenterWell (Atlanta, GA)
- …care, especially Medicare Advantage, with familiarity of HEDIS/STARS, medical risk adjustment , and clinical programming in primary care, complex care, ... has a strong emphasis on senior-focused primary care for members of Medicare Advantage health plans and is committed to providing personalized, high-quality primary… more
- CenterWell (Atlanta, GA)
- …at increasing clinical efficiencies, processes, education, and compliance as it relates to Medicare Risk Adjustment . Uses data-based insight to direct ... and Finance Strategy Lead - MRA in the PCO risk adjustment area implements and supports strategy...trends and develops internal initiatives to meet the ever-evolving business needs. Stays on the cutting age of technology… more
- Molina Healthcare (Atlanta, GA)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... without restrictions to practice and free of sanctions from Medicaid or Medicare . **PREFERRED EDUCATION:** Master's in Business Administration, Public Health,… more
- Humana (Atlanta, GA)
- …+ Experience in healthcare interoperability, including FHIR + Familiarity with CMS Risk Adjustment and Quality Measure reporting + Experience with healthcare ... monitor the efficacy of products and use customer and business partner feedback to adjusts products over time for...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- Evolent (Atlanta, GA)
- …of Medicare claims, episode and condition groupers, case/episode and risk adjustment , patient attribution methodologies, and network analysis and pod ... reason why diversity and inclusion are core to our business . Join Evolent for the mission. Stay for the...Senior Analyst, Performance Analytics to join our Performance Suite business unit. Our mission is to improve and innovate… more