- Atrium Health (Charlotte, NC)
- …This leaders will be a key subject matter expert for clinical documentation and risk adjustment coding within the enterprise. This position focuses on ... This clinical position uses clinical/nursing knowledge and understanding of national coding guidelines and standards of compliance to improve overall quality and… more
- Trinity Health (Fort Lauderdale, FL)
- …Medicare programs and regulations including fraud and abuse and Medicare Hierarchical Condition Coding Risk Adjustment + Excellent analysis and presentation ... experience in a leadership role in a capacity developing and implementing risk adjustment , coding , wellness assessment, and analytics programs and processes… more
- Somatus (Mclean, VA)
- …physical and mental well-being + Community engagement opportunities + And more! The Director , Medicare Risk Adjustment (MRA) will lead the execution ... strategy and implementation of the organization's Risk Adjustment Programs to optimize the programs'...Finance and Analytics team to establish risk adjustment analytics such as predictive modeling for coding… more
- Centene Corporation (Columbia, SC)
- …of interventions at the provider and market level. + Subject matter experts for proper risk adjustment coding and CMS data validation + Work in conjunction ... practice coding patterns, education and training regarding risk adjustment to ensure accurate CMS payment...include Provider Relations, Quality as well as the Medical Director for the state assigned to ensure compliance of… more
- Centene Corporation (Yuma, AZ)
- …of interventions at the provider and market level. + Subject matter experts for proper risk adjustment coding and CMS data validation + Work in conjunction ... practice coding patterns, education and training regarding risk adjustment to ensure accurate CMS payment...include Provider Relations, Quality as well as the Medical Director for the state assigned to ensure compliance of… more
- Centene Corporation (Carson City, NV)
- …of interventions at the provider and market level. + Subject matter experts for proper risk adjustment coding and CMS data validation + Work in conjunction ... practice coding patterns, education and training regarding risk adjustment to ensure accurate CMS payment...include Provider Relations, Quality as well as the Medical Director for the state assigned to ensure compliance of… more
- Henry Ford Health System (Troy, MI)
- … payment models and other value based initiatives. Under minimal supervision from the Director , Risk Adjustment and Value Based Payment, the Manager is ... a high degree of autonomy focusing on improving Mid-Revenue Cycle processes, Risk Adjustment and HCC Coding program management, Accountable Care Organization… more
- HCA Healthcare (Tampa, FL)
- … coding and documentation improvement education to Providers. + Assists the Director Coding Operations Division Support in reviewing progress against business ... Coder (CPC(R)) credential or Certified Professional Coder - Hospital (CPC-H(R)) or Certified Risk Adjustment Coder (CRC) EXPERIENCE: + Experience with Cerner and… more
- Hackensack Meridian Health (Edison, NJ)
- …preferably in the following areas and/or disciplines is required in the areas of: a. Risk Adjustment /HCC Coding . b. Physician Coding . + Knowledge of ... of positive change. Under the general direction of the Revenue Cycle Director and Coding Manger, Physician Services Division, the ** Coding Quality Educator,… more
- Emanate Health (Covina, CA)
- …MSO personnel on HCC and STAR measures related tasks. Responsible to ensure the IPA risk adjustment factor maintains or exceeds 1.0 and achieves or improves upon ... Responsible for the oversight of HCC Program and STAR measures coding related functions. The HCC coding specialist will work with the IPA Director , Health… more
- Scripps Health (San Diego, CA)
- …Categories (HCCs) for accuracy and compliance as relates to Outpatient CDI. Monitors Risk Adjustment Factor (RAF) Scores. . Directs instructions and education ... open to change, go ahead and unlock your potential. Join Scripps asSenior Director , Revenue Cycle where you will have primary accountability for the oversight of… more
- Commonwealth Care Alliance (Boston, MA)
- …and reviews, including claims reviews; call center and digital communications reviews; Medicare Risk Adjustment , HCC, clinical and coding reviews; DRG and ... **Why This Role is Important to Us:** **Position Summary:** The Director , Quality & Control Assurance reports to the VP of Quality & Control Assurance is responsible… more
- Mitsubishi Chemical Group (Jersey City, NJ)
- …on real-world evidence, and creating hope for all facing illness. The Director , Government Accounts will be responsible for the development and implementation of ... insure coordinated/targeted pull through with the field Sales and Marketing. The Director , Government Accounts will maintain a high level of collaboration and… more
- Point32Health (Canton, MA)
- …claims data, coding schemes (ICD-9/ICD-10, CPT/HCPCS, DRGs), and health status risk adjustment + Prior experience with Business Intelligence tools such as ... Reporting to the Vice President of Network and Provider Performance Management, the Director of Network and Provider Analytics plays a strategic leadership role with… more
- VIP Care (Tampa, FL)
- …Medical Record (EMR) system to review Patient records + Proficiency in Medicare Risk Adjustment + Effective communication and interpersonal skills + Proficiency ... Summary/Objective: The Senior Medical Director is responsible for leading efforts to develop...delivery of healthcare including, but not limited to clinical coding (ICD-10, CPT, and DRG), medical record review, population… more
- Elevance Health (Richmond, VA)
- …practice managers, population health and quality directors on improving STARS/HEDIS or Risk Adjustment performance. + Six Sigma or formal process improvement ... Work schedule: Monday - Friday, standard business hours.** The Medical Director Clinical Programs is responsible for designing and implementing clinical programs… more
- Highmark Health (Dover, DE)
- …in a Healthcare-related field **Substitutions** + 6 years of combined experience with RN/LPN, Risk Adjustment HCC Coding , medical coding /billing, HEDIS, ... + None **EXPERIENCE** **Required** + 5-10 years of combined experience with RN/LPN, Risk Adjustment HCC Coding , medical coding /billing, HEDIS,… more
- Colorado State University (Fort Collins, CO)
- …vendors contracted with insurance companies to review medical records under the governmental risk adjustment assessments + Performs other duties as requested by ... 11:59pm (MT) on06/16/2024 Description of Work Unit Billing and Coding The Billing and Coding department within...101 Student Services. The Title IX Coordinator is the Director of the Office of Title IX Programs and… more
- Humana (Columbus, OH)
- …Network Optimization, Clinical Services, Value-Based contracting, HEDIS and Risk Adjustment . Reporting to the Associate Director and/or Market Development ... the health plan, physician, providers and practice managers. + Supporting HEDIS & Risk Adjustment initiatives and Ohio Department of Medicaid quality initiatives… more
- Louisiana Department of State Civil Service (Baton Rouge, LA)
- …requirements. Certifies and recommends approval to the Human Resources Director for all proposed activities. Independently evaluates, initiates and processes ... with the Human Resources Manager and the Human Resources Director . Advises personnel liaisons in area of responsibility of...codes have been used in reporting FMLA absences, request adjustment form for any entries which need correcting. Contacts… more
