- Elevance Health (Atlanta, GA)
- …is strongly preferred + Healthcare business knowledge related to Risk Adjustment Payment Methodology strongly preferred + Advanced skills in Microsoft Office ... consult and guide internal stakeholders on effective use and interpretation of risk adjustment data and KPIs + Provides expertise to lower-level consultants on… more
- Molina Healthcare (Atlanta, GA)
- …role will be responsible for work around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling ... complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data to evaluate healthcare...risk models including the various CMS models for Medicare Advantage members, the HHS model for Commercial ACA… more
- Datavant (Atlanta, GA)
- …+ Knowledge and understanding of HCC mapping and models + Experience with coding Medicare , Commercial and Medicaid risk adjustment charts + Understanding of ... staff/external partners + Oversee the development of complex and advanced ICD-10 and Hierarchical Condition Category (HCC) coding and... Medicare , Commercial and Medicaid risk adjustment business logic and coding +… more
- Elevance Health (Atlanta, GA)
- …and guide provider groups on effective use and interpretation of risk adjustment data and KPIs + Advanced skills in Microsoft Office Suite, especially ... to the development and implementation of strategic initiatives aimed at improving risk adjustment outcomes. + Monitor the effectiveness of implemented solutions… more
- Humana (Atlanta, GA)
- …operational efficiency, and focus on medical cost management, medical risk adjustment and stars. Highly skilled with broad, advanced technical experience, ... senior executives on matters of significance, and as an advanced subject matter expert competent to work at very...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more