- CenterWell (Boston, MA)
- **Become a part of our caring community and help us put health first** The Medicare Risk Adjustment Strategy Lead in the PCO risk adjustment area ... at increasing clinical efficiencies, processes, education, and compliance as it relates to Medicare Risk Adjustment . Uses data-based insight to direct… more
- Datavant (Boston, MA)
- …and managing in a remote environment (2+ years) + 3+ years of experience working with Medicare , ACA, and/or Medicaid risk adjustment models + 5+ years of ... vision for healthcare. **What we're looking for:** The incoming Risk Adjustment Analytics Manager will be stepping...with other managers and the department director to set strategy and mobilize the team to be as performant… more
- CenterWell (Boston, MA)
- …within the Primary Care Organization. ** Strategy :** + In partnership with AVP, Risk Adjustment and AVP, MRA Strategy , responsible for driving ongoing ... Documentation (APD) tool) + Responsible for performance management and strategy development for PCO risk adjustment...up to 20% **Preferred Qualifications** + Proven experience with Medicare Advantage risk adjustment functions.… more
- Humana (Boston, MA)
- …factors. This position utilizes financial projection and analytics skills while working in Medicare risk adjustment . Additionally, you will work to build ... possess financial or actuarial background. Begins to influence department's strategy . Makes decisions on moderately complex to complex issues...working with Medical Claims or other healthcare data + Medicare Risk Adjustment Experience +… more
- Humana (Boston, MA)
- …+ Demonstrated knowledge of Medicare Advantage program + Demonstrated knowledge of risk adjustment and the Stars quality program + Experience in managed care ... in a combination of disciplines. Begins to influence department's strategy . Makes decisions on moderately complex to complex issues...by: + Providing legal advice and support for Humana's Medicare Advantage lines of business; + Advising on … more
- Humana (Boston, MA)
- …a focus on learning strategies and adult learning theories + Working knowledge of Medicare Risk Adjustment and/or Stars + Experience using Articulate ... solutions are necessary or relevant. Begins to influence department's strategy . Makes decisions on moderately complex to complex issues...Information This role will be responsible for supporting the Medicare Risk Adjustment Team within… more
- Highmark Health (Boston, MA)
- …in the organization's value-based reimbursement programs. Strong knowledge of risk adjustment methodologies and reporting/regulatory requirements and CMS ... central role in the development and execution of the strategy for a given initiative for transformation of workflows...outcomes strategic plan development. + 1 year experience with Medicare STARS, Medicaid HEDIS, risk revenue value… more
- CenterWell (Boston, MA)
- …care, especially Medicare Advantage, with familiarity of HEDIS/STARS, medical risk adjustment , and clinical programming in primary care, complex care, ... strong emphasis on senior-focused primary care for members of Medicare Advantage health plans and is committed to providing...develop and support the MSO's National Clinical Vision and Strategy , directly lead a team of regional & area… more
- Deloitte (Boston, MA)
- …+ Experience with Medicaid waivers (ie, 1115, 1915 b/c, 1332) + Experience with risk adjustment mechanisms + Experience with health care reform and working ... (and the providers that serve them) to support its business strategy . This includes changing the organization's culture, modernizing specific functions and… more