- Humana (Hartford, CT)
- …to drive efficient, effective, and compliant risk adjustment processes. This Risk Adjustment Risk Management lead position will be responsible ... Management Lead acts as a consultant to the Risk Adjustment team leaders, as programs and...Management and is responsible for oversight of the Risk Adjustment Operations processes. The Risk… more
- Baylor Scott & White Health (Hartford, CT)
- …and external sources to provide insight to decision-makers. This role supports program management activities around risk adjustment data management ... procedure documentation. + Oversee updates to department policies and procedures regarding risk adjustment data management . + Remain current on CMS Risk… more
- Datavant (Hartford, CT)
- …and roadmap for the Data Integration pod within the Retrospective Risk Adjustment Coding Product Suite + **Client Data Management :** Oversee secure and ... to realize our bold vision for healthcare. **Role Overview** As a Product Manager, Risk Adjustment Coding Data Integration, you will own the data strategy and… more
- Datavant (Hartford, CT)
- …and life experiences to realize our bold vision for healthcare. As an Auditor, HCC Risk Adjustment Coder, you will review medical records to identify and code ... using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical… more
- Datavant (Hartford, CT)
- …vision for healthcare. We're looking for experienced and credentialed Auditing Team Lead, HCC Risk Adjustment Coding to become an integral part of our team. The ... for education opportunities in both quality and productivity to management for review and/or action. + Assists in auditing...95% or higher. + Any other tasks required by management . What you will bring to the table: +… more
- Datavant (Hartford, CT)
- …for healthcare. Auditing Supervisor serves as a working supervisor with oversight and management of Risk Adjustment team members. This includes monitoring ... findings on a daily basis, including education on time management and best coding practices. + Provide coaching and...the role. + Report trends for education opportunities to management for review and/or action. + Motivate team members… more
- Datavant (Hartford, CT)
- …using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical ... skills, problem solve, ability to work in a remote environment, and time management skills. + Working knowledge of the business use of computer hardware and… more
- Hartford HealthCare (Hartford, CT)
- …recognition programs and other common practices across the system. *JOB SUMMARY:* The Risk Adjustment Coder Educator develops and implements an enterprise-wide ... risk adjustment coding and documentation education program to support documentation...documentation practices among contracted providers that comply with CMS risk adjustment program requirements and ICD 10… more
- The Cigna Group (Bloomfield, CT)
- Responsible for coordination and implementation of daily processes related to IFP Risk Adjustment (RA) programs, including the Risk Adjustment Data ... Review and Audit Senior Analyst position recognizes experience in Risk Adjustment Data Validation audits (RADV), ...identify risks or program gaps and communicate effectively to management in a timely manner + Demonstrates ability to… more
- The Cigna Group (Bloomfield, CT)
- Job Summary: The Risk Adjustment Quality & Review Analyst in IFP brings medical coding and Hierarchical Condition Category expertise to the role, evaluates ... and any additional applicable rule set. * Utilize HHS' Risk Adjustment Model to confirm accuracy of...programs, raising any identified risks or program gaps to management in a timely manner. * Communicate effectively across… more
- The Cigna Group (Bloomfield, CT)
- …complex medical documentation for diagnosis code accuracy and compliance in support of the HHS' Risk Adjustment (RA) program and Risk Adjustment Data ... expertise in RA programs. * Contributes to execution of Risk Adjustment programs, and other IFP programs,...of Professional Coders (AAPC) or the American Health Information Management Association (AHIMA), in one or more of the… more
- Datavant (Hartford, CT)
- …The individual will provide superior quality by performing audits pertaining to risk adjustment coding efforts. The individual will be responsible for ... role in ensuring coding compliance and accuracy + Monitor the performance of the Risk Adjustment Operations both internally and with coding vendors + Provides… more
- Wolters Kluwer (Hartford, CT)
- …| Wolters Kluwer (https://www.wolterskluwer.com/en/solutions/health-language)** **Coder Workbench Solution:** ** Risk Adjustment Software | Health Language ... or Central time zone, have a solid understanding of risk adjustment in the Healthcare Technology space,...+ Provide comprehensive and insightful sales reports to senior management . + Identify and leverage market opportunities for business… more
- Vatica Health (Springfield, MA)
- …collaboration, the PEM I is responsible for improving provider satisfaction, quality and risk adjustment performance in the Vatica Health program, thus impacting ... relationships. + Develop strategic, comprehensive, provider-specific plans to advance risk adjustment and quality performance, participation and provider… more
- CVS Health (Hartford, CT)
- …the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical ... Coder) or CCS-P (Certified Coding Specialist-Physician) required. + CRC (Certified Risk Adjustment Coder) + Computer proficiency including experience with… more
- Amentum (Hartford, CT)
- …the successful development of correctional intelligence programs to assist in the management of violent extremist and high- risk offenders **REQUIRED SKILLS AND ... designed for the following purpose: Building Responsive and Effective Prison Management Systems to Repatriate, Rehabilitate, Reintegrate, and Prosecute FTFs and may… more
- Amazon (Windsor, CT)
- …daily one-on-one interaction. Additionally, the OMR will participate in weekly case management review meetings as necessary. As an OMR, you will independently assess ... medical providers as needed, and learn about OSHA regulations, risk , and analysis. The OMR will function as a...have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support… more
- Hartford HealthCare (Hartford, CT)
- …department, third party and regulating agencies' policies and procedures and standards of risk management . 8. Attends Palliative Care Team rounds and all ... family and staff needs. The Palliative Care social worker provides support around adjustment to illness, decision making, eliciting goals of care and family coping… more
- Sedgwick (Springfield, MA)
- …unassisted up to $10M, including having the ability to address most complex adjustment issues pertaining to damages and coverage; to assist on even larger losses ... + Attention to detail and accuracy + Good time management and organizational skills + Ability to work independently...this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive… more
- Sedgwick (Springfield, MA)
- …regardless of size, including having the ability to address any complex adjustment issue and any medium sized and relatively complex National Account. **ESSENTIAL ... + Attention to detail and accuracy + Good time management and organizational skills + Ability to work independently...this or other roles.** **Sedgwick is the world's leading risk and claims administration partner, which helps clients thrive… more