- Kelsey-Seybold Clinic (Houston, TX)
- …the financial performance of Kelsey-Seybold's (KS) product lines and health plans. The MCA Risk Adjustment Clinical Documentation Specialist team is a ... highly-skilled team of Clinical Documentation Specialist in the outpatient setting providing chart review...Coding Preferred: N/A **License(s)** Required: Certified Risk Adjustment Coder (CRC) or Certified Documentation Education… more
- University of Miami (Hialeah, FL)
- …of CMS star rating, Vizient, and US News and World Report risk - adjustment systems to identify clinical documentation improvement opportunities. + ... worklet, please review this tip sheet (https://my.it.miami.edu/wda/erpsec/tipsheets/ER\_eRecruiting\_ApplyforaJob.pdf) . The Clinical Documentation Integrity (CDI) Second Level Reviewer… more
- Henry Ford Health System (Troy, MI)
- …capture of documentation within the medical record and therefore appropriate risk adjustment reimbursement. In addition, this position is responsible for ... The Director of Risk Adjustment & Value Based Payment...planning and coordinating education to medical providers related to clinical documentation improvement and clinical … more
- The Cigna Group (Dallas, TX)
- …on health plan coding initiatives guidelines and requirements of the Risk Adjustment program to ensure correct coding and documentation . + Conduct chart ... week** **Job Summary:** This role is responsible for supporting Cigna Medicare Advantage's Risk Adjustment & Stars program for assigned populations in an… more
- The Cigna Group (UT)
- …on health plan coding initiatives guidelines and requirements of the Risk Adjustment program to ensure correct coding and documentation . + Conduct chart ... ** Risk Adjustment Provider Educator** **_Incumbent_** **_candidate...historical and/or real time data. + Develop relationships with clinical providers/staff and communicate coding and documentation … more
- CVS Health (Northbrook, IL)
- …of professional healthcare experience required including some combination of: - Experience in risk adjustment , medical coding, and documentation - Experience ... for an enthusiastic team player to lead local market Medicaid Provider Engagement risk adjustment initiatives across the Aetna Better Health Plans. Reporting to… more
- CVS Health (Hartford, CT)
- …of experience in the health care industry, Medicaid operations, risk adjustment , or medical coding and documentation preferred- Knowledge of insurance ... team player to lead a suite of market focused Risk Adjustment Programs for a portfolio of...and direct local vendors when appropriate. + Engage with clinical team and specific clinics, medical groups, hospitals; attends… more
- Trinity Health (Syracuse, NY)
- …Recognizes and reports opportunities for documentation improvement to the Supervisor of Risk Adjustment Coding & Audit to develop and implement provider ... **Employment Type:** Full time **Shift:** **Description:** ** Risk Adjustment Coding Specialist - CNY...in a team environment and is responsible for reviewing clinical documentation and coding using HCC (Hierarchical… more
- Somatus (Mclean, VA)
- …lead the execution strategy and implementation of the organization's Risk Adjustment Programs to optimize the programs' clinical benefit, financial accuracy ... and performance of vendors or third-party administrators performing risk adjustment activities. + Drive effective auditing documentation practices. _Please… more
- ChenMed (Miami, FL)
- …and other support departments to review medical records and other clinical documentation to identify appropriate risk adjustment codes and quality gap ... and/or County laws and regulations related to coding and documentation guidelines for Risk Adjustment ...our members as well as correct reimbursement. + Identifies clinical coding and documentation trends and training… more
- CVS Health (Hartford, CT)
- …with an expertise in business operations in a health care setting with Medicare Risk Adjustment experience a plus. This position will support Medicare Risk ... manage and develop operational solutions to advance Medicare compliant risk adjustment activities for the CVS Accountable...work within the ACO Operations department on the Accurate Clinical Documentation (ACD) team to support the… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …maintain collaborative relationships with assigned providers / provider offices to improve risk adjustment coding and documentation accuracy and ... team members. Collaborates with internal teams to develop various clinical documentation and coding education materials. Engage...specificity of documentation changes + 3 years Risk Adjustment Coding/Auditing and experience with direct… more
- Martin's Point Health Care (Portland, ME)
- …and medical record documentation . Working closely with the Health Plan's Risk Adjustment Data Analytics and Data Architecture team on data gathering, ... Place to Work" since 2015. Position Summary The Senior Director of Risk Adjustment Operations in our Health Plan is responsible the overall development,… more
- Molina Healthcare (Topeka, KS)
- …Description** **Work Location - Kansas** **Job Summary** The AVP, Quality Improvement & Risk Adjustment is responsible for leading health plan execution for ... Risk Adjustment and Quality for all lines...Prepares, in collaboration and support with MHI Quality, required documentation for state Performance Improvement Projects. * Aligns with… more
- CareFirst (Baltimore, MD)
- …all chronic conditions are captured at the highest level of specificity to ensure Risk Adjustment Revenue is accurate and reflective of true managed care needs. ... collaborates with provider to ensure closure of quality and risk adjustment gaps in care. Consults on.... + Fulfill various requests for patient charts and clinical information made by the health plan that are… more
- Kelsey-Seybold Clinic (Houston, TX)
- …Official ICD-10-CM Guidelines for Coding and Reporting **Job Title: Supervisor Risk Adjustment & Quality Assurance** **Location: Pearland Administrative Office** ... Professional Coder) or CCS-P (Certified Coding Specialist-Physician), and CRC (Certified Risk Adjustment Coder) Preferred: CPMA (Certified Professional Medical… more
- Universal Health Services (Reno, NV)
- …years in CMS coding and documentation guidelines as well as HCC risk adjustment coding practices + CRC Required. + Additional Coding certification preferred ... accurate reporting of diagnoses and service codes to support optimal performance in risk adjustment and quality measurement. The scope of work will include… more
- MedKoder (Mandeville, LA)
- …hands-on production). Must have at least 1 year of specialized experience in Medicare Risk Adjustment disciplines- such as HCC, CCC HEDIS + Auditing experience a ... to providers. This includes the analysis and translation of medical and clinical diagnoses, procedures, injuries, or illnesses into designated numerical codes. This… more
- AdventHealth (Maitland, FL)
- …to effectively meet targeted engagement, clinical and economic outcomes. Ensure that risk adjustment related programs are performing and compliant and in all ... The Population Health Services Organization (PHSO) Senior Manager of Clinical Documentation Integrity (CDI) will be responsible...driving annual clinical initiatives related to the risk adjustment coding management for the populations… more
- University of Miami (Miami, FL)
- …the impact of documentation on patient care, quality metrics, risk adjustment , and correct reimbursement. Adheres to departmental and organizational ... encounters and how physician documentation translates into ICD-10-CM and HCC risk adjustment for claims submission to meet reporting requirements. + Ensure… more