- Baylor Scott & White Health (Nashville, TN)
- …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 (Nashville, TN)
- …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 (Nashville, TN)
- …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 (Nashville, TN)
- …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 (Nashville, TN)
- …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
- Datavant (Nashville, TN)
- …met. + Report trends for education opportunities in both quality and productivity to management for review and/or action. + Assists in coding to meet the monthly ... 95% or higher. + Any other tasks required by management . **What you will bring to the table:** +...ability to work in a remote environment and time management skills + Working knowledge of the business use… more
- Molina Healthcare (Bowling Green, KY)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management , risk management , risk adjustment , disease ... regarding utilization practices, guideline usage, pharmacy utilization and effective resource management . + Develops and implements a Utilization Management … more
- Molina Healthcare (Bowling Green, KY)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management , risk management , risk adjustment , disease ... Summary** Molina's Behavioral Health function provides leadership and guidance for utilization management and case management programs for mental health and… more
- Molina Healthcare (Bowling Green, KY)
- …**REQUIRED EXPERIENCE/KNOWLEDGE, SKILLS & ABILITIES:** * 2+ years of program and/or project management experience in risk adjustment and/or quality * 2+ ... years of experience supporting HEDIS engine activity, risk adjustment targeting and reporting systems * 2+ years of data analysis experience utilizing technical… more
- Molina Healthcare (Bowling Green, KY)
- **Job Description** **Job Summary** The Director, Clinical Data Acquisition for Risk Adjustment , is responsible for the implementation, monitoring, and oversight ... of all chart collection for Risk Adjustment , RADV, or ...as Electronic Medical Record (EMR) access. This position oversees management of training for all CDA team members as… more
- Molina Healthcare (Bowling Green, KY)
- …* Minimum 5 years people management experience * Minimum 5 years Risk adjustment audit/RADV experience * Demonstrated knowledge of and experience with chart ... **Job Summary** **Job Summary** The AVP, Clinical Data Acquisition is a key Risk Adjustment (QI) leader within the organization enterprise wide. This position… more
- Molina Healthcare (Bowling Green, KY)
- …**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...healthcare delivery environment, specifically with government sponsored programs, including risk revenue management , strategy and compliancy *… more
- Datavant (Nashville, TN)
- …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
- Amazon (Nashville, TN)
- …to the cloud? Are you skilled at helping executives address their enterprise risk management requirements using highly scalable computing architectures? The AWS ... - Lead a team to define innovative compliance and risk management approaches to customers that help...have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support… more
- Deloitte (Nashville, TN)
- …reimbursement, MS-DRG, APR-DRG, PSIs, HACs, POA, Vizient, Elixhauser, public profiling, and risk adjustment + Has strong interpersonal skills to collaborate with ... Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk & Forensic team helps client leaders translate multifaceted risk … more
- Amazon (Nashville, TN)
- …team. Are you ready to drive high-visibility, strategic, musculoskeletal disorder (MSD) risk reduction programs as well as leverage Lean methodologies to lead ... of Excellence (eCoE) Strategy and drive multiple cross-functional Global Ergonomics risk reduction initiatives. In this role you will provide technical expertise… more
- Amazon (Nashville, TN)
- …to the cloud? Are you skilled at helping executives address their enterprise risk management requirements using highly scalable computing architectures? The AWS ... - Builds a team that can define compliance and risk management approaches to customers that help...have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support… more
- Wolters Kluwer (Nashville, TN)
- …| 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
- Molina Healthcare (Bowling Green, KY)
- …with setting annual targets for each VBP/VBC in conjunction with national quality and risk adjustment VPs, Regional Directors of Quality/ Risk , Director of ... revenue management , strategy, and compliance + Knowledge of value based programs, risk adjustment models, quality metrics such as HEDIS and STARS, knowledge… more
- Amazon (Nashville, TN)
- …partner with all engineering teams to drive a systematic approach to address risk identification, mitigation, and management of safety solutions. This position ... stakeholders. In addition, you will be required to lead risk assessments, assist in the development and review of...Basic Qualifications - 3+ years of program or project management experience - 3+ years of defining and implementing… more