- Humana (Washington, DC)
- …+ Oversight and support of all Market MRA functions + Policies, procedures, training, and education for all risk adjustment functions Ensures integration of ... Reporting and Improvement (HQRI) organization as Senior Vice President (SVP), Risk Adjustment Operations and Interoperability. This key leadership position… more
- Somatus (Mclean, VA)
- …provider Network Management and the Quality Program to implement tactics for risk adjustment optimization, particularly for provider and member engagement ... Overview The Director, Medicare Risk Adjustment (MRA) will lead the...coding improvement opportunities, provider coding improvement opportunities, provider coding accuracy, risk score trending and… more
- Highmark Health (Washington, DC)
- …- Medicare Advantage, Medicaid, Affordable Care Act + Demonstrated knowledge of risk adjustment principals + Health Insurance and/or managed care industry ... time and budget and under circumstances involving multiple moderate-probability, moderate-impact risk factors. Manages a matrix group of employees and contractors… more
- The Cigna Group (Mclean, VA)
- …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 ... office diagnosis coding. Implement provider office education , where necessary, and provide formal training… more
- Bloomberg (Washington, DC)
- Bloomberg Economics - GeoEconomics - Country Risk Analyst **Washington, DC** Posted Mar 20, 2024 - Requisition No. 123986 With close to 50 economists and 200 ... and policy. We are seeking an expert on country risk analysis to join our growing team. **THE ROLE:**...the lead in building data sets and models that provide a more systematic way of understanding countries' geoeconomic… more
- Highmark Health (Washington, DC)
- … Risk Adjustment coding including documentation improvement, provider education , analyzing reports, and identifying process improvements. **ESSENTIAL ... anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation (RADV) Audits. Works closely with… more
- Lockheed Martin (Bethesda, MD)
- … education and support to the business units on workers' compensation matters\. ‒ Provide the following risk management support to the Missiles & Fire Control ... to the business units\. ‒ Manage the reporting and adjustment of claims\. ‒ Ensure compliance with all policy...M&A activity as necessary\. Respond to business units' ongoing risk management service needs; provide evidence of… more
- PNC (Tysons Corner, VA)
- …the company's success. As a Quantitative Analytics/Modeling Consultant within PNC's Model Risk Management organization, you can be based in Pittsburgh, PA or Tyson's ... validation of a mix of the following models: derivative pricing models, Value at Risk (VaR) models, asset and liability models measuring interest rate risk and… more
- RELX INC (Annapolis, MD)
- About the Business LexisNexis Risk Solutions is the essential partner in the assessment of risk . Within our Government vertical, our solutions assist government ... informed decisions to enhance investigations. You can learn more about LexisNexis Risk at the link below. https:// risk .lexisnexis.com/government About our Team… more
- RELX INC (Alexandria, VA)
- 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
- Zurich NA (Washington, DC)
- …and financial perspective. We work with our wellbeing partners and industry experts to provide the best advice and access to a wealth of lifestyle support. We're ... minimal travel to industry events/conferences. Working with an award-winning Risk Management team as part of a Global insurer...the opportunity to let us know of any reasonable adjustment or practical support needed when you apply. **Required… more
- Veterans Benefits Administration (Washington, DC)
- …the reported behaviors. The incumbent conducts behavioral threat assessments to provide recommendations for individualized risk mitigation strategies. Consults ... be accredited by an accrediting institution recognized by the US Department of Education to be credited towards qualifications. Provide only the attendance… more
- Bloomberg (Washington, DC)
- …will work closely with our modelling, geoeconomics and country teams to provide quantitative and qualitative estimates of the impact of trade and industrial ... Partner with global analysts (CGE modelers, geoeconomic analysts) to work on larger-scale risk scenarios (eg a Taiwan crisis). + Collaborate with CGE modelers to… more
- Somatus (Mclean, VA)
- …collaborative physician to provide oversight to nurse practitioner(s) performing risk adjustment visits in relevant states. + Provides physician leadership ... multi-state market geography. In addition, the Population Health Physician may support provider engagement and market level client relationships with a focus on… more
- RELX INC (Washington, DC)
- …and their networks. Our work products fill intelligence gaps with data analysis, provide timely and actionable findings to enable operational units to action our ... support in a multi-disciplinary team environment to deliver analytic products and provide appropriate briefing and visualizations for the customer that capture key… more
- Humana (Washington, DC)
- …something similar **Preferred Qualifications** + Knowledge and/or experience within the Stars Organization, Risk Adjustment and/or Provider . + PMP or CAPM ... Intake, Charter, RACI Model/Roles and Responsibilities, Governance Structure, Project Plan, Risk /Issues Tracking, etc. + Analyze project portfolio to ensure project… more
- WelbeHealth (Washington, DC)
- …and post-visit chart reviews + Oversee audits and participate in provider education programs to ensure compliance with CMS risk adjustments diagnosis coding ... with Coding Supervisor in identifying opportunities for HCC coding education **Job Requirements:** + Associates Degree preferred; three (3)...and auditing + Minimum of two (2) years of Risk Adjustment (HCC) coding experience in a… more
- Bristol Myers Squibb (Washington, DC)
- …environment. We offer a wide variety of competitive benefits, services and programs that provide our employees with the resources to pursue their goals, both at work ... and the healthcare community, driving scientific exchange to enhance medical education , data generation, insight generation and patients' access to medicine. The… more
- RELX INC (Washington, DC)
- …to measure and improve client satisfaction of our products. You will provide excellent customer support and value-added services to ensure retention and renewal ... with minimal supervision to develop strategies focused on customer retention, risk mitigation strategies, and renewal maintenance. + Identifying key contacts and… more
- Prime Therapeutics (Washington, DC)
- …for overseeing the development of recommended pricing terms; offer structure and risk analysis for highly complex and visible cases, primarily in the Health ... remain on a profitable basis and if needed, leverages contractual or internal adjustment remedies** **In partnership with Sales and Client Engagement, provide … more