- Northeast Georgia Health System, Inc (Gainesville, GA)
- …of 5+ years experience with increasing responsibilities in developing and executing risk coding programs.Knowledge of, and experience with, utilizing EPIC ... Excel, PowerPoint and Word). Essential Tasks and ResponsibilitiesShall develop a comprehensive risk coding accuracy program and curriculum in dyad with matrix… more
- Cambia Health Solutions, Inc (Renton, WA)
- …for driving improvement in healthcare? Do you have experience in provider engagement and performance management? We're searching for a talented Government Programs ... a Government Programs Provider Performance Director, you'll develop provider engagement strategies to drive performance improvements in critical objectives such… more
- ArchWell Health (Venice, FL)
- … Network development and specialty referrals Documentation and accurate coding Quality improvement and HEDIS measures Utilization management Transitional care and ... physician meetings and reviews of currently/recently hospitalized patients and those at risk for clinical deterioration. The Market Medical Director will support the… more
- CVS Health (Northbrook, IL)
- …including some combination of: - Experience in risk adjustment, medical coding , and documentation - Experience in provider engagement strategies Preferred ... enthusiastic team player to lead local market Medicaid Provider Engagement risk adjustment initiatives across the Aetna...of the team. + Partner with segment product, sales, network , clinical teams to implement processes aimed at strengthening… more
- Somatus (Mclean, VA)
- …establish risk adjustment analytics such as predictive modeling for coding improvement opportunities, provider coding improvement opportunities, provider ... for risk adjustment optimization, particularly for provider and member engagement activities. + Manage processes needed to conduct at home wellness visits.… more
- Humana (Columbus, OH)
- …responsible for driving provider performance programs, goals and improvement metrics for network providers and partnerships. The Engagement Professional is an ... Network Optimization, Clinical Services, Value-Based contracting, HEDIS and Risk Adjustment. Reporting to the Associate Director and/or Market Development… more
- CVS Health (Hartford, CT)
- …- 2+ years of experience in the health care industry, Medicaid operations, risk adjustment, or medical coding and documentation preferred- Knowledge of insurance ... for an enthusiastic team player to lead a suite of market focused Risk Adjustment Programs for a portfolio of Aetna Better Health Medicaid Plans. Reporting… more
- Capital One (Mclean, VA)
- …security, network security, cyber security, data protection), information systems risk management, information systems auditing, or a combination + At least 1 ... Center 1 (19052), United States of America, McLean, Virginia Principal Associate Cyber Risk & Analysis, Technology Audit (Hybrid) Capital One's Audit function is a… more
- Capital One (Mclean, VA)
- Center 1 (19052), United States of America, McLean, Virginia Manager, Cyber Risk & Analysis- Technology Audit (Hybrid) **Capital One's Audit function is a dedicated ... including critical technology functions, cloud-based infrastructure, emerging technology, cybersecurity, risk management, application, and third-party management, as well as… more
- St. Luke's University Health Network (Orwigsburg, PA)
- …and back-office processes, including staff, physician, and patient scheduling, billing/ coding and medical records. Ensures appropriate office policy and procedures ... best practices. + Carry out directives of St. Luke's Network to ensure compliance with all federal and local...and physician education as required to maintain optimal procedure coding . + Within guidelines established, approve invoices and major… more
- Centene Corporation (Tallahassee, FL)
- …education, including writing and updating orientation materials + Manages Network performance for assigned territory through a consultative/account management ... performance + Drives provider performance improvement in the following areas: Risk /P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost and utilization, etc. +… more
- Tufts Medicine (Burlington, MA)
- …through extensive interaction with physicians, nursing staff, other patient caregivers, and coding staff to ensure that documentation reflects the level of service ... conditions and procedures, for accurate representation of severity of illness, expected risk of mortality, and complexity of care of the patient through extensive… more
- LifePoint Health (Brentwood, TN)
- …in the clinic setting to capture an accurate representation of the severity of illness, risk adjustment and facilitate proper coding . This CDI role will focus on ... physicians, group practices, and administration. * Participate in continuing education for risk adjustment, CDI requirements, and coding guidelines. * Adhere to… more
- Capgemini (Scottsdale, AZ)
- …access control (RBAC), entitlement management, and policy enforcement. + ** Network Security:** Understanding of network protocols, firewalls, intrusion ... detection systems, VPNs, and other network security technologies. + **Operating Systems:** Proficiency in various operating systems (Windows, Linux, Unix, etc.) and… more
- Mastercard (Tampa, FL)
- …meetings, knowing your people, managing career development, and understanding who is at risk * Provide and facilitate timely feedback, coaching in the moment, and ... Mastercard Way behaviors through their behavior, recognitions, coaching, and employee engagement * Manage and optimize budgets, forecasting, and cost allocation… more
- Erickson Living (Pompton Plains, NJ)
- …a neighborhood of Morris County, New Jersey. We're part of a growing network of communities developed and managed by Erickson Senior Living, a national provider ... payroll for the medical center + Coordinating training of staff and providers on coding and billing issues with the Managers of Reimbursement and Coding and… more
- The Cigna Group (Baltimore, MD)
- …assigned **(Mid-Atlantic (MD, DC & VA) region** in terms of financial profitability, engagement of provider network and membership growth. + Delivering our ... of the market that assists in the growth and development of the provider network . The External Representative is the primary conduit to the providers and the… more
- SSM Health (St. Louis, MO)
- …and collection of professional fees; (6) Personnel management and related policies; (7) Risk management and quality assurance; and (8) Coding compliance. + ... and special clinical programs as reasonably requested. + Responsible for all risk management, coding compliance and quality assurance activities and functions… more
- Highmark Health (Charleston, WV)
- …including its drivers in disease-based management, care management, utilization management, and risk coding opportunities as well as pharmacy strategies. + ... performance improvement. Accountable for meeting targets in areas of Risk Revenue, Quality/stars, affordability, reimbursement/contracting trend, network … more
- Ankura (Dallas, TX)
- …Ankura, we know that collaboration drives results. This position supports the Ankura Risk , Forensics & Compliance practice - one of six practices focused on client ... of the software development process; (iii) interviewing personnel responsible for network and software security (iv) overseeing static and dynamic code analysis;… more
