- Providence (Portland, OR)
- …of WA, OR and CA. **The Role:** As the Director of Risk Adjustment and Strategic Accounts at Providence Health Plan, you will be the cornerstone of our ... strategic vision. You will oversee risk adjustment programs, spearhead provider education, and...ideas to life. + **Advocacy & Impact:** Represent Providence Health Plan in advocacy, shaping the future of healthcare… more
- Molina Healthcare (Vancouver, WA)
- …Description** **Job Summary** The Director , Clinical Data Acquisition for Risk Adjustment , is responsible for the implementation, monitoring, and oversight ... years' experience in managed healthcare, including at least 4 years in health plan Risk Adjustment or clinical data acquisition/chart retrieval roles *… more
- Molina Healthcare (Vancouver, WA)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... **JOB DESCRIPTION** **Job Summary** Molina's Behavioral Health function provides leadership and guidance for utilization...EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in… more
- Molina Healthcare (Vancouver, WA)
- …experience with proven relationship management responsibilities * Proven experience in risk adjustment , quality, and provider engagement. * Demonstrated ability ... Risk & Quality Solutions (RQS) works with health plan risk & quality leaders to...**PREFERRED EXPERIENCE:** 10+ years managed care experience specifically within Risk Adjustment and/or Quality To all current… more
- Molina Healthcare (Vancouver, WA)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, Medicaid,… more
- Molina Healthcare (Vancouver, WA)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, Medicaid,… more
- Molina Healthcare (Vancouver, WA)
- …Claims applications -_** **which underpin essential business functions such as HEDIS reporting, Risk Adjustment (RA), and Health Plan Reporting.** + **_Azure ... with project teams to find solutions to ensure the success of the Health Performance Assessment System. * Takes a leadership role in evolving Molina application… more
- Molina Healthcare (Vancouver, WA)
- …**Job Summary** The In-Home Assessment Program Manager is part of our innovative Risk Adjustment department to assist our diverse team of data leaders, ... risk adjustment experts, and developers in the...by acting as a key business partner to the Director , Prospective Programs, Market & Segment Leaders, health… more
- Molina Healthcare (Vancouver, WA)
- …and risk adjustment VPs, Regional Directors of Quality/ Risk , Director of Value Based Programs, and local health plan resources. + Responsible for ... existing programs and contracts, and ensures alignment with local health plan budgets and forecasts. Accountable for designing and...strategy, and compliance + Knowledge of value based programs, risk adjustment models, quality metrics such as… more
- Bristol Myers Squibb (Portland, OR)
- …work with:** The District Business Manager reports to the Regional Business Director and works collaboratively across a matrix sales organization to appropriately ... license in good standing issued by your state of residence; and, 3) a driving risk level deemed acceptable by the Company. \#LI-Remote If you come across a role that… more