- Independent Health (Buffalo, NY)
- …perks, benefits and a culture that fosters growth, innovation and collaboration. **Overview** The Medicare Risk Adjustment Program Manager will be ... requirements and ensure program deliverables are achieved on time. The Medicare Risk Adjustment Program Manager will be accountable for the… more
- UCLA Health (Los Angeles, CA)
- Description As the Medicare Advantage Risk Adjustment Performance Improvement Consultant, you will be responsible for: + Serving as a Subject Matter Expert ... (SME) for risk adjustment with contracted IPAs + Collaborating...experience * Knowledge of HIPAA regulations * Knowledge of Medicare Advantage, STARS/HEDIS program , and NCQA technical… more
- UCLA Health (Los Angeles, CA)
- Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment , you will be an expert in risk adjustment coding ... and documentation, working closely with physicians, IPA coders, and risk adjustment teams associated with the health...(II), and HCPCS coding systems required + Knowledge of Medicare Advantage STARS/HEDIS program and NCQA technical… more
- McLaren Health Care (Flint, MI)
- …with internal departments and leadership to promote activities that support a successful risk adjustment program . **This position is fully remote.** **Equal ... in Health Information Management, Healthcare Business Services, or equivalent program with emphasis in coding. + Certified Professional Coder... or HCC coding. + Two years' experience in Medicare Risk Adjustment (MRA) HCC… more
- Molina Healthcare (Rochester, NY)
- …Health Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities. Ensures ... complex Value-Based Care contracts have engagement plans to meet annual quality and risk adjustment goals. Drives coaching and collaboration with providers to… more
- Marshfield Clinic (Marshfield, WI)
- …Risk Adjustment Services is a key leader for commercial and government program actuarial and risk adjustment topics. This role provides financial ... in the world!** **Job Title:** Director of Actuarial and Risk Adjustment Services **Cost Center:** 682891378 SHP-Actuarial...or be excluded from participation in any federally funded program , including Medicare and Medicaid. This is… more
- Point32Health (Canton, MA)
- …specific to risk score trends, truncation report, data/claims submissions and program performance to support risk adjustment analytics; deliver timely ... individual will be responsible for supporting critical data submission functions for the Risk Adjustment Department (RAD), including submissions to CMS and state… more
- BlueCross BlueShield of North Carolina (NC)
- …Arrangements (ACO/CIO) and Medicare Quality Initiatives (Stars and Risk Adjustment ). + Excellent presentation, communication and relationship building ... Carolina (Blue Cross NC) is seeking a Medical Director, Medicare Strategy to join our Health Care division. In...recruit potential partners for new and innovative product and program offerings. **What You Bring (Hiring Requirements):** + MD… more
- VNS Health (Manhattan, NY)
- …records, including ICD 10 CM or current coding system and medical record systems for Medicare Advantage Risk Adjustment required + 2 years of experience in ... identifying opportunities to support precise clinical documentation. Collaborating with the Risk Adjustment and Quality teams, you'll help shape educational… more
- Banner Health (AZ)
- …efforts in support of achieving organizational strategic initiatives related to the organization's Risk Adjustment program goals. This position is also ... RN will assist with chart reviews, risk adjustment prep, patient out reach for Medicare ...partnership. 7. Participates in or leads Risk Adjustment projects designed to improve program offerings… more