- Merck & Co. (Durham, NC)
- …and other groups as required.The Lab Senior Maintenance Technician will provide maintenance supporting vaccine process equipment operations. Takes appropriate action ... and delivered on schedule. Responsible for supporting departmental vision that will provide for continuous improvement in all aspects of the operation.Must be able… more
- 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 priorities ... excellence initiatives. Responsible for staff management and development, quality, service excellence, workplace experience and financial outcomes. This clinical… more
- The University of Vermont Health Network (Burlington, VT)
- …contribute to medical student and psychiatry resident education and training; provide consultation and limited direct service around behavior management ... bonus will be paid out as a $2,500 pay adjustment in the first paycheck following the completion of...6 months (1040 hours/prorated for part time) of satisfactory service in the department hired into. This requires a… more
- BlueCross BlueShield of North Carolina (NC)
- …role. Evaluates and monitors provider performance to achieve excellence in risk adjustment coding. Participates in regular provider meetings and/or ... Coordinates and leads Provider facing meetings to achieve excellence in risk adjustment coding. + Collaborates with Risk Data Analytics and Value Program… more
- Point32Health (Canton, MA)
- …updates, discuss strategic initiatives and improvement opportunities + Work collaboratively with risk adjustment provider educators and the quality assurance ... enjoy the important work we do every day in service to our members, partners, colleagues and communities. To... provider outreach and ongoing communications/reporting for all risk adjustment programs and initiatives. Serve as… more
- Point32Health (SC)
- …Commercial and Medicaid HCCs through medical record reviews. The Risk Adjustment Coding Specialist II reviews provider documentation of ICD-10-CM (including ... provide analyses and recommendations to improve overall provider documentation and coding. The Risk Adjustment Coding Specialist II will review medical… more
- Point32Health (SC)
- …Commercial and Medicaid HCCs through medical record reviews. The Risk Adjustment Coding Specialist I reviews provider documentation of ICD-10-CM (including ... medical records to determine if diagnostic codes (ICD-9/10-CM) are accurately reflecting the provider documentation. The Risk Adjustment Coding Specialist I… more
- Centene Corporation (Jefferson City, MO)
- …benefits including a fresh perspective on workplace flexibility. **Position Purpose:** The Director of Risk Adjustment Programs is a key member of the Risk ... internal and external activities to achieve revenue appropriateness objectives. The Director of Risk Adjustment Programs is the subject matter expert (SME) that… more
- Somatus (Mclean, VA)
- …provider Network Management and the Quality Program to implement tactics for risk adjustment optimization, particularly for provider and member engagement ... well-being + Community engagement opportunities + And more! The Director, Medicare Risk Adjustment (MRA) will lead the execution strategy and implementation… more
- Baystate Health (Springfield, MA)
- The Prospective Outpatient Risk Adjustment Coder supports risk adjustment optimization activities that improve value-based care and population health by ... record before provider visits and uses ICD-10 CM coding guidelines and risk adjustment model regulations to identify missed opportunities to address chronic… more
- Trinity Health (Fort Lauderdale, FL)
- …or perform data mining and data-driven analysis to forecast/evaluate the performance of the risk adjustment program and refine annual risk adjustment ... program strategies to achieve optimal performance. Incorporate data-driven analysis into the risk adjustment processes. + Develop and monitor metrics of program… more
- Insight Global (Fort Myers, FL)
- …programs for provider education -Identifying issues and determining impact to risk adjustment models and reports results for various products and services ... service coding . 3+ Experience with Medicare risk adjustment coding and HCC coding (retrospective...prospective experience) . Valid CPC certification . Experience with provider education -Bachelors Degree or associates degree in related… more
- Humana (Columbus, OH)
- …part of our caring community and help us put health first** The Risk Adjustment Senior Program Delivery Professional strategically identifies, develops, and ... of situations or data requires an in-depth evaluation of variable factors. The Risk Adjustment Senior Program Delivery Professional develops programs designed to… more
- The Cigna Group (Bloomfield, CT)
- …regulations and polices related to documentation and coding. + Knowledgeable of Medicare Risk Adjustment . + Proficiency with ICD-10-CM coding and guidelines. + ... obtained through a cable broadband or fiber optic internet service provider with speeds of at least..._###@cigna.com_ _for an update on your application or to provide your resume as you will not receive a… more
- HSBC (New York, NY)
- …all relevant risk areas eg credit risk , counterparty credit risk , securitization, and Credit Valuation Adjustment ('CVA'). GRPA currently maintains a ... the establishment of interpretations and governance processes to mitigate regulatory risk . GRPA also monitors new rule developments and other ongoing changes… more
- Firefly Health (Watertown, MA)
- …quality care. Areas will include, but not limited to, capturing accurate risk adjustment , population segmentation service design, care management/high ... modifiable Total Cost of Care reduction areas of opportunity. + Provide medical leadership, guiding the development and implementation of evidence-based clinical… more
- The Cigna Group (Chattanooga, TN)
- …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 ...obtained through a cable broadband or fiber optic internet service provider with speeds of at least… more
- The Cigna Group (Bloomfield, CT)
- …assigned populations in an operational market. The role will be accountable for assigned provider groups reaching risk adjustment and stars related annual ... care. The role will work under the direction of Risk Adjustment & Stars Provider ...obtained through a cable broadband or fiber optic internet service provider with speeds of at least… more
- Healthfirst (NY)
- …key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for- Service ), Diagnosis Related Groups ... State/CMS. + Assist and monitor direct payment initiatives from the state for Provider Organizations + Responsible for contract analysis and fee schedule modeling. +… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** Supports Risk Adjustment & Stars organization to optimize Risk Adjustment revenue and coding accuracy through ... for developing performance monitoring reports and analytics related to Risk Adjustment & Stars programs and processes.... excellence. Must be able to effectively communicate and provide positive customer service to every internal… more
