- Elevance Health (Atlanta, GA)
- ** Risk Adjustment Process Expert I** **Location:** Louisville, KY **Hybrid 1:** This role requires associates to be in-office 1 - 2 days per week, fostering ... an accommodation is granted as required by law. The ** Risk Adjustment Process Expert** is...adjustment experience strongly preferred. + 3 years of Medicare /Medicaid experience is strongly preferred. + Strong oral, written… more
- Baylor Scott & White Health (Atlanta, GA)
- + **JOB SUMMARY** The Risk Adjustment Analyst Sr is responsible for monitoring and oversight of the end-to-end encounter management workflow. This position ... to decision-makers. This role supports program management activities around risk adjustment data management and submissions to...Participates in the workgroup to resolve encounter data and process issues. + Analysis and forecasting of risk… more
- Datavant (Atlanta, GA)
- …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
- Humana (Dallas, GA)
- …exceptional follow up skills + Valid Driver's license and reliable transportation + Medicare Risk Adjustment knowledge **Additional Information** Work at ... public speaking and/or presentation skills with healthcare providers + Risk Adjustment knowledge + Familiar with coding...to surrounding provider offices As part of our hiring process , we will be using an exciting interviewing technology… more
- Humana (Atlanta, GA)
- …+ Certified Risk Coder (CRC) + Experience interacting with healthcare providers + Medicare Risk Adjustment knowledge + Analyzing data to build unique ... Coding Educator is responsible for creating and executing the risk adjustment strategy for each provider groups....Word, Excel and PowerPoint + Analyzing Data to drive process improvement + Experience with public speaking and presentation… more
- Molina Healthcare (Atlanta, GA)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... necessity. + Participates in and maintains the integrity of the appeals process , both internally and externally. Responsible for the investigation of adverse… more
- Molina Healthcare (Atlanta, GA)
- …with setting annual targets for each VBP/VBC in conjunction with national quality and risk adjustment VPs, Regional Directors of Quality/ Risk , Director of ... existing contracts and programs while also leading a continuous process of innovation to identify new value based contracting...strategy, and compliance + Knowledge of value based programs, risk adjustment models, quality metrics such as… more
- Humana (Atlanta, GA)
- …Qualifications** + Bachelors Degree + Knowledge and/or experience within the Stars Organization, Risk Adjustment and/or Provider + PMP or CAPM Certification + ... include but not limited to Intake, Charter, Governance Structure, Project Plan, Risk /Issues Tracking, etc. + Analyze project portfolio to ensure project updates,… more