- 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
- 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
- Humana (Boston, MA)
- …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 (Boston, MA)
- …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
- Humana (Boston, MA)
- …part of our caring community and help us put health first** The Director, Risk Adjustment Strategy Advancement will provide business intelligence and ... business segments and the company at large. The Director, Risk Adjustment Strategy Advancement requires an in-depth...Requirements** + WAH requirements: Must have the ability to provide a high-speed DSL or cable modem for a… more
- Elevance Health (Woburn, MA)
- …managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), ... **Business Information Consultant Senior - Provider Economics** The **Business Information Consultant Senior** is...8 years of relevant experience; or any combination of education and experience which would provide an… more
- CenterWell (Boston, MA)
- …with MRA Strategy and Analytics teams to establish risk adjustment analytics to identify coding improvement opportunities, provider coding improvement ... entities within the Primary Care Organization. **Strategy:** + In partnership with AVP, Risk Adjustment and AVP, MRA Strategy, responsible for driving ongoing… more
- Commonwealth Care Alliance (Boston, MA)
- …+ Serve as a resource for primary care site to answer questions regarding risk adjustment , corrective CPT coding, Medicare & Medicaid coding guidelines and ... the guidance of the Manager for Billing, Coding, & Provider Documentation this position will support internal & external...from AHIMA) or Certified Professional Coder (CPC), and Certified Risk Adjustment Coder (CRC) from the American… more
- Boston Public Schools (Boston, MA)
- …for students with disabilities, and differentiated instruction for all students + Provide support to special education teachers regarding research-based and ... , Mentally Disabled Special Education , Mild/Moderate Disabilities Special Education , Multiple Disabilities Student Services, Adjustment Counselor Student… more
- Boston Public Schools (Boston, MA)
- …for students with disabilities, and differentiated instruction for all students + Provide support to special education teachers regarding research-based and ... Available: 1 Job Categories Special Education , General Special Education Student Services, Adjustment Counselor Student Services, Psychologist Student… more
- CenterWell (Boston, MA)
- …efficiencies, processes, education , and compliance as it relates to Medicare Risk Adjustment . Uses data-based insight to direct process improvement efforts ... and Finance Strategy Lead - MRA in the PCO risk adjustment area implements and supports strategy...bi-weekly payment for their internet expense. + Humana will provide Home or Hybrid Home/Office employees with telephone equipment… more
- Datavant (Boston, MA)
- …The individual will provide superior quality by performing audits pertaining to risk adjustment coding efforts. The individual will be responsible for daily ... role in ensuring coding compliance and accuracy + Monitor the performance of the Risk Adjustment Operations both internally and with coding vendors + Provides… more
- RELX INC (Cambridge, MA)
- …LexisNexis Risk Solutions is the essential partner in the assessment of risk . Within our Insurance vertical, we provide customers with solutions and decision ... and analytics to assist them in evaluating and predicting risk and enhancing operational efficiency. Our insurance risk...the vertical market. + Partner with the Industry Market Education team to monitor state and federal legislative, policy,… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …delivery of high-quality, trustable clinical data to support key initiatives around quality, risk adjustment , medicare stars, and interoperability. This is a key ... + Collaborate with cross-functional teams, including clinical operations, performance measurement, and risk adjustment , to execute on data procurement & usage… more
- Harvard University (Cambridge, MA)
- …of a diverse population of adolescents and adults, eating disorders; multicultural adjustment issues; fluency in a foreign language (Chinese, Japanese, Korean, or ... pre-employment reference and background screening. + Harvard University is unable to provide work authorization and/or visa sponsorship. + This position has a 90-day… more
- RELX INC (Cambridge, MA)
- About the Business LexisNexis Risk Solutions is the essential partner in the assessment of risk . Within our Business Services vertical, we offer a multitude of ... Laundering/Counter Terrorist Financing, Identity Authentication & Verification, Fraud and Credit Risk mitigation and Customer Data Management. You can learn more… more
- Humana (Boston, MA)
- …analyze large data sets + Knowledge of healthcare compliance, mainly primary care and risk adjustment , pharmacy knowledge a plus + Certified Coder (CPC, CRC, ... us put health first** CenterWell Senior Primary Care (PCO) is a growing provider organization that currently operates about 340+ senior focused primary care centers… more
- Boston Public Schools (Boston, MA)
- …Certification by the Commonwealth of Massachusetts Department of Elementary and Secondary Education as a School Adjustment Counselor/School Social Worker + ... 5060577 Job Description Students with Limited or Interrupted Formal Education (SLIFE) Social Worker Office of Social Work(OSW) &...support plan for each student within the program. + Provide or coordinate mental health services for students on… more
- Sedgwick (Boston, MA)
- …(RTW) and accommodation efforts through negotiation with client, treatment provider and claimant; completes all accommodation/RTW related jurisdictional or client ... employers to determine specific information regarding employment area (ie training/ education needed, physical demands, wages and benefits, availability, etc.);… more
- Boston Public Schools (Boston, MA)
- …and English dual-language school dedicated to providing an asset-driven education for deaf and hard-of-hearing children. Our language-rich, innovative environment ... Language (ESL) license at the appropriate level is highly preferred. Bilingual Education Endorsement (BEE) is required for a content area teaching position.… more