- CVS Health (Northbrook, IL)
- …including some combination of: - Experience in risk adjustment, medical coding , and documentation - Experience in provider engagement strategies Preferred ... enthusiastic team player to lead local market Medicaid Provider Engagement risk adjustment initiatives across the Aetna...of the team. + Partner with segment product, sales, network , clinical teams to implement processes aimed at strengthening… more
- ChenMed (Miami, FL)
- …JOB DUTIES/RESPONSIBILITIES:** + Educates clinicians and non-clinician office staff on coding guidelines, documentation standards, and appropriate Medicare Risk ... HRDD. + Works closely with clinical and HRDD (High Risk Disease Detection) leadership to make sure coding...Collaborates with Operations Directors, Market Chief Medical Officers and Network Directors to identify areas of opportunities in HRDD.… more
- Somatus (Mclean, VA)
- …establish risk adjustment analytics such as predictive modeling for coding improvement opportunities, provider coding improvement opportunities, provider ... for risk adjustment optimization, particularly for provider and member engagement activities. + Manage processes needed to conduct at home wellness visits.… more
- Capital One (Mclean, VA)
- …security, network security, cyber security, data protection), information systems risk management, information systems auditing, or a combination + At least 1 ... Center 1 (19052), United States of America, McLean, Virginia Principal Associate Cyber Risk & Analysis, Technology Audit (Hybrid) Capital One's Audit function is a… more
- Capital One (Mclean, VA)
- Center 1 (19052), United States of America, McLean, Virginia Manager, Cyber Risk & Analysis- Technology Audit (Hybrid) **Capital One's Audit function is a dedicated ... including critical technology functions, cloud-based infrastructure, emerging technology, cybersecurity, risk management, application, and third-party management, as well as… more
- Amazon (Arlington, VA)
- …a network that crosses the entire plant, identify where in the real-world availability risk lies and to plan exponential network growth. * Work in an agile, ... looking for a Software Development Engineer to join our Network Data Modelling Services (NDMS) team. Our Software Development...manages the technical program and PMT manages the customer engagement , roadmap of the product. 3. Why should I… more
- St. Luke's University Health Network (Orwigsburg, PA)
- …and back-office processes, including staff, physician, and patient scheduling, billing/ coding and medical records. Ensures appropriate office policy and procedures ... best practices. + Carry out directives of St. Luke's Network to ensure compliance with all federal and local...and physician education as required to maintain optimal procedure coding . + Within guidelines established, approve invoices and major… more
- Centene Corporation (Bowling Green, KY)
- …Acts as a liaison between Tier II providers (large PCP groups not on risk contracts and providers with upside only incentives) and the health plan. Manages ... Network performance for assigned territory through a consultative/account management...approach. Drives provider performance improvement in the following areas: Risk /P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost and utilization,… more
- Centene Corporation (Springfield, IL)
- …between Tier III and Tier IV providers (small to medium PCP groups not on risk contracts and providers with upside only incentives) and the health plan. Manages ... Network performance for assigned territory through a consultative/account management...approach. Drives provider performance improvement in the following areas: Risk /P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost and utilization,… more
- American Express (Phoenix, AZ)
- …American Express stand behind our members. **Responsibilities:** + Interface on key network design tenants for both physical and logical connectivity using TCP/IP ... and SNA protocols + Partner closely with Core Infrastructure Network teams, to facilitate the optimum deployment of Mainframe Network capabilities + Design… more
- AdventHealth (Maitland, FL)
- …metrics, as well as participate in process improvement efforts serving as a risk adjustment coding resource for network physicians, PHSO committees, ... develop and lead a broad and diversified range of risk adjustment coding services for the AdventHealth...Assurance (QA) and compliance programs to effectively meet targeted engagement , clinical and economic outcomes. Ensure that risk… more
- Tufts Medicine (Burlington, MA)
- …through extensive interaction with physicians, nursing staff, other patient caregivers, and coding staff to ensure that documentation reflects the level of service ... conditions and procedures, for accurate representation of severity of illness, expected risk of mortality, and complexity of care of the patient through extensive… more
- Walmart (Bentonville, AR)
- …or puppet) to automate repetitive tasks and releases for a more efficient workflow. Coding : Requires knowledge of: Coding standards and guidelines; Coding ... standards and tools (Eg, Monday.com, Linx, Embold etc.) for software coding /configuration. Take initiative to learn the fundamentals of different coding… more
- LifePoint Health (Brentwood, TN)
- …in the clinic setting to capture an accurate representation of the severity of illness, risk adjustment and facilitate proper coding . This CDI role will focus on ... physicians, group practices, and administration. * Participate in continuing education for risk adjustment, CDI requirements, and coding guidelines. * Adhere to… more
- HUB International (Roseville, CA)
- …for their excellence throughout the insurance community. **WHY CHOOSE HUB?** Throughout our network of more than 450 HUB offices in North America, we offer a ... processing. * Open, read, route, and distribute incoming mail, including scanning and coding /indexing when necessary. * Process outgoing mail as needed. * May assist… more
- Capgemini (TX)
- …access control (RBAC), entitlement management, and policy enforcement. + ** Network Security:** Understanding of network protocols, firewalls, intrusion ... detection systems, VPNs, and other network security technologies. + **Operating Systems:** Proficiency in various operating systems (Windows, Linux, Unix, etc.) and… more
- Erickson Living (Hingham, MA)
- …on the South Shore in Hingham, Massachusetts. We're part of a growing network of communities developed and managed by Erickson Senior Living, a national provider ... payroll for the medical center + Coordinating training of staff and providers on coding and billing issues with the Managers of Reimbursement and Coding and… more
- Lumeris (OH)
- …medication adherence, step therapy). + Ensures comprehensive and accurate documentation and coding of risk -adjusted patient populations to ensure appropriate ... **Position Summary:** Responsible for improving Accountable Care Team (Provider) engagement . Establishes significant "mindshare" within our Accountable Care Team… more
- Honeywell (Charlotte, NC)
- …Patch, Run) + Risk and Control oversight of DB environment ensuring engagement with DB Security and Engineering teams + Provide guidance to Operational Database ... Collaborate on Database Automation activities to improve process efficiency and risk compliance. + Drive Stability initiatives by proactively reviewing and… more
- Capital One (Plano, TX)
- …and necessary updates. Lead continuous monitoring activities and updates to risk assessments, audit universe, and audit plan.** + **Oversee multiple, concurrent ... IT Operations, and Cloud audits across assigned portfolios.** + **Develop engagement planning documentation and audit programs to ensure adequate coverage of… more