- Commonwealth Care Alliance (Boston, MA)
- …regulations and policies related to documentation and coding + Knowledge of Medicare Risk Adjustment Documentation with Certified Risk Adjustment ... operational coding initiatives at Commonwealth Care Alliance (CCA). The Clinical Documentation Sr. Specialist will serve as...resource for primary care site to answer questions regarding risk adjustment , corrective CPT coding, Medicare &… more
- Datavant (Boston, MA)
- …to realize our bold vision for healthcare. **Role Overview** As a Product Manager, Risk Adjustment Analytics Products, you will contribute to the strategy and ... execution of analytics capabilities that power Datavant's risk adjustment solutions. You'll drive the development of robust, scalable, and actionable analytics… more
- Commonwealth Care Alliance (Boston, MA)
- 011260 CCA-Revenue Cycle Management Position Summary: The Risk Adjustment Business Analyst is responsible for understanding and interpreting complex programs, ... gathering and transformation methodology, and will play an essential role in driving Risk Adjustment (RA) Program performance. Supervision Exercised: * No, this… more
- Humana (Boston, MA)
- **Become a part of our caring community and help us put health first** The Risk Adjustment Coder conducts quality assurance coding of medical records and ICD-10 ... and Medicaid Services (CMS) and other government agencies. The Risk Adjustment Coder assumes ownership and leads...Coder** ensures coding is accurate and properly supported by clinical documentation within the health record. +… more
- Datavant (Boston, MA)
- …using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical ... role in translating clinical documentation into precise codes that reflect the complexity and severity of a patient's health status. **You will:** + The… more
- Humana (Boston, MA)
- …to drive initiatives that relate to risk adjustment coding and documentation accuracy. The Clinical Support Team is seeking a senior professional who ... Senior Market Consultation/Partnership Professional engages and partners with internal risk adjustment coders, business stakeholders, physicians, physician… more
- CenterWell (Boston, MA)
- …first** The IPA Coding Leader manages a diverse team responsible for ensuring clinical documentation supports accurate coding and is reflective of the disease ... with IPA strategic partners to develop market-specific strategies to promote accurate clinical documentation , ensures all state, federal and internal policies… more
- Tufts Medicine (Boston, MA)
- …Performance Metrics (eg, HEDIS, Stars, and clinical outcomes). b.) 25% - Risk Adjustment (accurate RAF coding, documentation , and patient complexity). ... of Department of Medicine strategies with network and payer priorities. 10. Supports risk adjustment , care model design, and other payer-facing initiatives. 11.… more
- East Boston Neighborhood Health Center (East Boston, MA)
- …for their psychiatrically complex patients, consistent with experience. Demonstrates excellent clinical judgement in assessing changes in risk , enlisting the ... patients and may be required to demonstrate age specific competency, depending upon clinical assignment, in a variety of clinical settings throughout the health… more
- Tufts Medicine (Lowell, MA)
- …Medical Officer for Quality, the Melrose Wakefield Hospital Senior Director Quality, Risk Management & Patient Safety and the Lowell General Hospital Vice President, ... activities will include the coordination, development, implementation, evaluation and adjustment of workflows and initiatives consistent with program objectives.… more
- Travelers Insurance Company (Boston, MA)
- …resolve the company's most severe and/or complex Life Science medical products, clinical trial and pharmaceutical bodily injury claims, as well as General Liability ... CLAIM HANDLING: + Directly handle assigned severe/complex Life Science medical products, clinical trial and pharmaceutical bodily injury claims, as well as General… more