- The University of Vermont Health Network (Camp Johnson, VT)
- …prevention and early intervention, collaborating with numerous community service providers, identifying and addressing developmental challenges and/or psycho-social ... support to maximize each family's physical, social and emotional strengths. We provide skilled nursing services for pregnant/postpartum women with higher risk … more
- CenterWell (Carson City, NV)
- …administration, or related field + Well-versed in various reimbursement methodologies, including risk adjustment , fee for service , Medicare, etc. + ... our caring community and help us put health first** The Associate Director, Risk Adjustment oversees quality assurance audits of medical records, ICD-10-CM, CPT,… more
- The Cigna Group (Nashville, TN)
- …activities for the Cigna Compliance Department, with particular emphasis on Coding, Risk Adjustment and Coding Decisions. Collaborates with Cigna Compliance ... fast-paced environment. The candidate must demonstrate solid command of risk adjustment . This compliance team member must...obtained through a cable broadband or fiber optic internet service provider with speeds of at least… more
- The Cigna Group (Bloomfield, CT)
- …if do not live near a Cigna Office]** We have an immediate need to strengthen our Risk Adjustment and Stars Enablement team. The Risk Adjustment and ... solution changes for the ongoing needs of CMS Medicare Risk Adjustment processes and systems. The **Medicare...obtained through a cable broadband or fiber optic internet service provider with speeds of at least… more
- Somatus (Mclean, VA)
- …provider Network Management and the Quality Program to implement tactics for risk adjustment optimization, particularly for provider and member engagement ... well-being + Community engagement opportunities + And more! The Sr. Director, Medicare Risk Adjustment (MRA) will lead the execution strategy and implementation… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Specialist supports prospective risk adjustment via concurrent review and supplemental ... data CMS filing, HHS- Risk Adjustment Data Validation (RADV) audit and...platforms. + Must be able to effectively communicate and provide positive customer service to every internal… more
- Fallon Health (Worcester, MA)
- …+ * Working knowledge of the provider -based healthcare industry, claims processing, provider billing or Risk Adjustment strongly preferred + * ... among the nation's top health plans for member experience, service , and clinical quality. We believe our individual differences,...Summary of Purpose** : The primary role of the Risk Adjustment Analyst (RAA) will be to… more
- Humana (Columbus, OH)
- …and help us put health first** As a Program Delivery Lead specializing in Risk Adjustment Strategic Partnerships, you will lead the development and execution of ... leadership, fostering strategic alliances to improve quality metrics. Your expertise in risk adjustment and deep understanding of internal processes will enable… more
- Fallon Health (Worcester, MA)
- …feedback and submit to Manager for provider education efforts + Update risk adjustment software with all relevant chart review observations + Meet or ... among the nation's top health plans for member experience, service , and clinical quality. We believe our individual differences,...FCHP patient charts for the purpose of validating regulatory Risk Adjustment scores. The Chart Review Specialist… more
- Banner Health (Phoenix, AZ)
- …and develops clinical strategies and educational initiatives around the impact that accurate risk adjustment has on the performance of our MA, MSSP, Medicaid, ... accountable care organization that joins Arizona's largest health care provider , Banner Health, and an extensive network of primary...as the clinical DYAD to the Executive Director of Risk Adjustment , co-leading a robust team that… more
- The Cigna Group (Denver, CO)
- **Summary** The Medicare Risk Adjustment Advanced Analytics team is searching for a highly motivated and collaborative person to build new data processes, expand ... analytics. You will work closely with colleagues across the Risk Adjustment business, data science, and data...obtained through a cable broadband or fiber optic internet service provider with speeds of at least… more
- Bank of America (Phoenix, AZ)
- Research and Adjustment Rep III- National Service & Solutions Phoenix, Arizona **Job Description:** **JOB DESCRIPTION:** This job is responsible for resolving ... procedures. Key responsibilities include investigating daily incoming research and adjustment inquiries, resolving differences, answering service requests and… more
- HSBC (New York, NY)
- …all relevant risk areas eg credit risk , counterparty credit risk , securitization, and Credit Valuation Adjustment ('CVA'). GRPA currently maintains a ... the establishment of interpretations and governance processes to mitigate regulatory risk . GRPA also monitors new rule developments and other ongoing changes… more
- Principal Service Solutions (De Soto, KS)
- …our dynamic team as we transform the way high-tech companies work! Principal Service Solutions is a leading technical workforce provider entrusted to safeguard ... power of the high-tech workforce around the world. Principal Service Solutions is hiring Lead Adjustment Technicians...is occasionally exposed to toxic or caustic chemicals and risk of electrical shock. + The noise level in… more
- The Cigna Group (Chattanooga, TN)
- …populations in an operational market. The role will be accountable for assigned provider groups reaching risk adjustment related annual metrics. This ... assigned market. Lead Analyst will be primary contact for provider groups on Risk Adjustment ...obtained through a cable broadband or fiber optic internet service provider with speeds of at least… more
- The Cigna Group (Denver, CO)
- …on topics including, but not limited to: preventative and quality outcome metrics, risk adjustment , medical cost management, etc. + Schedules, prepares for and ... to Health Services, Medical Economics, Sales, and Stars & Risk Adjustment in order to develop solutions...obtained through a cable broadband or fiber optic internet service provider with speeds of at least… more
- The Cigna Group (Atlanta, GA)
- …includes Market Provider Performance, Sales, Clinical Operations, Stars & Risk Adjustment , Finance , Cross-Segment Contracting, Provider Relations, ... and/or operational issues with providers. + Leading Stars & Risk Adjustment outcomes through local Provider...obtained through a cable broadband or fiber optic internet service provider with speeds of at least… more
- The Cigna Group (Maitland, FL)
- …Market Provider Performance, Sales, Health Services, Clinical, Stars & Risk Adjustment , Finance, Marketing, Cross-Segment Contracting, Provider ... relationships in order to drive optimal performance on Stars, risk adjustment , utilization management, and overall financial...obtained through a cable broadband or fiber optic internet service provider with speeds of at least… more
- Independent Health (Buffalo, NY)
- …impacts on pricing outcomes. + Establish and implement claims review processes to support risk adjustment . Analyze data and provide strategic insights to ... and commitment to diversity and inclusion. **Overview** As a Risk Revenue Analyst-Senior the incumbent will provide ...financial performance. + Ensure compliance with CMS regulations and risk adjustment methodologies. + Develop and execute… more
- PNC (Tysons Corner, VA)
- …company's success. As a Quantiative Analytics/Modeling Consultant Sr. within PNC's Market Risk Management organization, you will be based in Pittsburgh, PA or Tysons ... We are seeking an accomplished Model Developer to develop and maintain our Market Risk and Counterparty Credit Risk Models. The role involves developing and… more
