- 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
- Datavant (Atlanta, GA)
- … risk adjustment charts + Understanding of Medicare, Commercial and Medicaid risk adjustment business logic and coding + Knowledge and understanding ... vision for healthcare . We're looking for a Risk Adjustment Trainer to help us uplevel...members of Ciox team + Expertise and understanding of risk adjustment business logic +… more
- Highmark Health (Atlanta, GA)
- …This job provides end-to-end management, delivery and support to new and existing Risk Adjustment Programs. The incumbent will deliver value to the Health ... and deliver large and small scale projects that advance business outcomes and achieve strategic objectives relative to new...and achieve strategic objectives relative to new and existing Risk Adjustment Programs. Supports other key objectives… 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...benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also… more
- Datavant (Atlanta, GA)
- …using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical ... in health data exchange. Our vision is that every healthcare decision is powered by the right data, at...and time management skills. + Working knowledge of the business use of computer hardware and software to ensure… more
- Cognizant (Atlanta, GA)
- …implementation methodology around enrollment, reconciliation, encounters and risk adjustment programs in the government sponsored healthcare market. You ... and government programs particularly within enrollment, reconciliation, encounters and risk adjustment areas. . Strong capabilities and experience in… more
- Molina Healthcare (Atlanta, GA)
- …regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... **RED ED** **U** **C** **A** **TI** **O** **N** **:** Master's in Business Administration, Public Health, Healthcare Administration, etc. **PR** **E** **FE**… more
- Molina Healthcare (Atlanta, GA)
- …regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... of sanctions from Medicaid or Medicare. **PREFERRED EDUCATION:** Master's in Business Administration, Public Health, Healthcare Administration, etc. **PREFERRED… more
- Molina Healthcare (Atlanta, GA)
- …**Preferred License, Certification, Association** Six Sigma Certification PMI Certification Business Analytics/ Risk Management Workforce Certification To all ... deploy workforce management strategies nationwide. Partner with leaders by strategically identifying business needs, and propose solutions in line with the needs of… more
- CenterWell (Atlanta, GA)
- …entities within the Primary Care Organization. **Strategy:** + In partnership with AVP, Risk Adjustment and AVP, MRA Strategy, responsible for driving ongoing ... (APD) tool) + Responsible for performance management and strategy development for PCO risk adjustment at the division and market level; Partners with Clinical… more
- CenterWell (Atlanta, GA)
- …first** The Market Partnership and Finance Strategy Lead - MRA in the PCO risk adjustment area implements and supports strategy and targeted initiatives aimed at ... processes, education, and compliance as it relates to Medicare Risk Adjustment . Uses data-based insight to direct...trends and develops internal initiatives to meet the ever-evolving business needs. Stays on the cutting age of technology… more
- RELX INC (Atlanta, GA)
- About the Business LexisNexis Risk Solutions is the essential partner in the assessment of risk . Within our Business Services vertical, we offer a ... Laundering/Counter Terrorist Financing, Identity Authentication & Verification, Fraud and Credit Risk mitigation and Customer Data Management. You can learn more… more
- Datavant (Atlanta, GA)
- …BS degree in business , technology or related field + Knowledge of healthcare industry, payment models, risk adjustment , medical coding, physician ... in health data exchange. Our vision is that every healthcare decision is powered by the right data, at...between internal resources and customers in support of custom risk adjustment projects and reports on project… more
- RELX INC (Atlanta, GA)
- …of our GRC team? About the role: We are seeking an experienced Governance, Risk , and Compliance (GRC) Analyst to lead the development and implementation of our ... successful candidate will have a deep understanding of cybersecurity frameworks, risk management, and compliance standards, and will work collaboratively with… more
- Elevance Health (Atlanta, GA)
- …processes. **How you will make an impact:** + Serves as final arbiter regarding the Risk & Recovery's Retrospective Risk Adjustment (RA) Coding Team. + ... recommendations and solutions based on trends and results. + Provides feedback to Risk & Recovery leadership on performance improvement opportunities as a result of… more
- Evolent (Atlanta, GA)
- …knowledge of Medicare claims, episode and condition groupers, case/episode and risk adjustment , patient attribution methodologies, and network analysis and ... selves to work. That's one reason why diversity and inclusion are core to our business . Join Evolent for the mission. Stay for the culture. **What You'll Be Doing:**… more
- Amazon (Atlanta, GA)
- …across industries, market segments, and technical domains to drive transformative business outcomes. As a Principal-level advisor, you will be responsible for ... team of experts that help customers realize their desired business outcomes when using the AWS Cloud. We work...a culture of collaboration, empathy, and inclusion 10. Balance risk and quality while creating mechanisms to address recurring… more