- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …identify opportunities for performance improvement and further education . + Summarize and provide feedback to risk adjustment and/or provider group ... Establish and maintain collaborative relationships with assigned providers / provider offices to improve risk adjustment... Adjustment Coding/Auditing and experience with direct provider education + Health Insurance/ managed care… more
- Centene Corporation (Oklahoma City, OK)
- …sites regarding the National Committee for Quality Assurance (NCQA) HEDIS measures and risk adjustment . Provides education for HEDIS measures, appropriate ... and NCQA requirements. + Collects, summarizes, trends, and delivers provider quality and risk adjustment ...encounters). + Identifies specific practice needs where Centene can provide support. + Develops, enhances and maintains provider… more
- HCA Healthcare (Campbell, CA)
- …We care like family! Jump-start your career as a(an) Manager of Quality - Risk Adjustment Programs today with HCA Healthcare. **Benefits** HCA Healthcare, offers ... join our team as a(an) Manager of Quality - Risk Adjustment Programs. We care for our...urgent care centers. We are HCA Healthcare's graduate medical education leader. We provide direction for over… more
- Excellus BlueCross BlueShield (Buffalo, NY)
- …right for you, we encourage you to apply! Job Description: Summary: The Risk Adjustment Coding Coordinator is responsible for various aspects of decision-making ... coding policies to ensure accurate diagnosis coding. This position is responsible for risk adjustment coding and quality assurance validation for the following… more
- Commonwealth Care Alliance (Boston, MA)
- …claims, encounters, diagnoses, and provider data. + Familiarity with CMS risk adjustment methodologies and HCC coding preferred. + Experience with data ... the Director of Encounter Data Management within the Revenue Cycle Department, the ** Risk Adjustment Data Developer** is responsible for the design, development,… more
- Fairview Health Services (St. Paul, MN)
- …Coder - Hospital (CPC-H), Certified Clinical Documentation Specialist-Outpatient (CCDS-O), Certified Risk Adjustment Coder (CRC) **Preferred** Education + ... documentation for clinical conditions and procedures to reflect severity of illness, risk adjustment , accurate coding, accuracy of patient outcomes, and… more
- CareOregon (Portland, OR)
- …Responsibilities Reporting + Provide dashboards, reports, and analysis related to risk adjustment activities. + Prepare annual receivable estimate for final ... Washington, Utah, Idaho, Arizona, Nevada, Texas, Montana, or Wisconsin. Job Title Risk Adjustment Analyst Department Finance Exemption Status Exempt Requisition… more
- Commonwealth Care Alliance (Boston, MA)
- …without reminders or prompting from management. * Working knowledge of the provider -based healthcare industry and Risk Adjustment preferred. Required ... 011260 CCA-Revenue Cycle Management Position Summary: The Risk Adjustment Business Analyst is responsible...ensuring all identified gaps are addressed timely * Support Provider Network Management * Associate will be responsible for… more
- MedKoder (Mandeville, LA)
- …a flexible schedule. Description: MedKoder, LLC is seeking a remote Professional HCC Risk Adjustment Coder who will apply both technical and specialized ... government regulations while identifying opportunities for increased financial success. The HCC Risk Adjustment Coder provides coding services to health systems… more
- MVP Health Care (Schenectady, NY)
- …data sources to identify members with likely risk gaps across. + Provide regular reporting of Risk Adjustment programs and identify opportunities ... Professional, Risk Adjustment Analyst Headquarters Office, 625...abilities along with proven ability to analyze, report and provide insight on large sets of data + Intermediate… more
- UCLA Health (Los Angeles, CA)
- Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment , you will be an expert in risk adjustment coding and ... documentation, working closely with physicians, IPA coders, and risk adjustment teams associated with the health plan. You will: + Conduct medical record audits… more
- UNC Health Care (Chapel Hill, NC)
- …impact HCC Persistency must be documented at least annually. The Risk Adjustment Coordinator creates queries/prompts to the provider according to the process ... well-being of the unique communities we serve. Summary: The Risk Adjustment Coordinator will be responsible for...the claim for billing. Assist with creation and updating education tip sheets and tools for providers and other… more
- Humana (Boise, ID)
- …a part of our caring community and help us put health first** The Risk Adjustment Compliance Professional 2 supports the organization's adherence to governmental ... and contractual requirements, with a focus on risk adjustment operations. The role involves varied...vary based on demonstrated job related skills, knowledge, experience, education , certifications, etc. $65,000 - $88,600 per year This… more
- Datavant (Trenton, NJ)
- …and life experiences to realize our bold vision for healthcare. We're looking for a Risk Adjustment Trainer to help us uplevel our Risk Adjustment ... of HCC mapping and models + Experience with coding Medicare, Commercial and Medicaid risk adjustment charts + Understanding of Medicare, Commercial and Medicaid … more
- Excellus BlueCross BlueShield (Rochester, NY)
- …of a project. This position is accountable for the performance of vendors within Risk Adjustment . Leads in the identification and selection of vendors by ... to ensure realization of the expected value from the relationship. Executes risk adjustment vendor contracts and contract renewal negotiations. The incumbent… more
- Elevance Health (Richmond, VA)
- …effectively consult and guide internal stakeholders on effective use and interpretation of risk adjustment data and KPIs + Provides expertise to lower-level ... Consultant with project management skills; or any combination of education and experience, which would provide an...is strongly preferred + Healthcare business knowledge related to Risk Adjustment Payment Methodology strongly preferred +… more
- CVS Health (Columbus, OH)
- …Government Programs experience including Medicare, Commercial ACA, and/or Medicaid. + Risk adjustment working knowledge and understanding. + Process development ... to include milestones, tasks, and target/actual dates of completion. + Support provider performance that improves risk score accuracy through meaningful… more
- BlueCross BlueShield of North Carolina (NC)
- …of relevant actuarial experience. **Bonus Points** + Experience in Medicare Advantage Risk Adjustment highly preferred **What You'll Get** + The opportunity ... or analytical projects, ensuring timeliness, compliance, and quality of work + Provide proactive and strategic thought leadership of ways to improve processes,… more
- WGNSTAR (De Soto, KS)
- …company with a global footprint. Primarily focused on the semiconductor industry, we provide a platform for you to expand your career with knowledge gained ... all corporate safety protocols and report unsafe conditions. + Assist Adjustment Technicians with routine installations and/or maintenance on assigned products. +… more
- Molina Healthcare (Detroit, MI)
- …Health Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities. ... 3 providers have a Provider Engagement plan to meet annual quality & risk adjustment performance goals. * Drives provider partner coaching and… more