- The Cigna Group (Raleigh, NC)
- …independently prioritize and manage multiple responsibilities + Prior experience with ACA risk adjustment program strongly preferred If you will be working at ... join the IFP Analytics team responsible for identifying and sizing new risk adjustment opportunities that not only create better health outcomes for patients but… more
- Centene Corporation (Olympia, WA)
- …operations, or data analysis/reporting experience in the healthcare industry. Risk adjustment experience highly preferred . Previous managed care or Medicare ... flexibility. **Position Purpose:** Manage the business processes related to risk adjustment and quality improvement across Centene's for assigned products and plans.… more
- Tufts Medicine (Burlington, MA)
- …Coder (CPC). 2. Two (2) years of outpatient billing, coding, risk adjustment , and primary care adult medicine experience. ** Preferred Qualifications:** 1. ... coding standards as well as CMS and Commercial Risk Adjustment guidelines. This position has extensive knowledge of overall...2. Certified Risk Adjustment Coder (CRC) highly preferred . 3. Five (5) years of outpatient billing, coding,… more
- CVS Health (New Albany, OH)
- …paced, deadline oriented environment. + Strong written and verbal communication. ** Preferred Qualifications** + Risk adjustment program experience within ... opportunity for a Program Manager to join our Risk Adjustment Retrospective Program for ACA, Medicare, MMP and DSNP...Medicare. **Education** + Bachelor's Degree preferred or equivalent professional work experience. **** **Pay Range**… more
- The Cigna Group (Birmingham, AL)
- …audience. + Prefer candidates with some familiarity of Medicare Advantage and risk adjustment . + Actuarial experience is preferred , but not required. If you ... role will work with a series of stakeholders on setting our risk adjustment strategy. Reporting to the Medicare Advantage Revenue Finance lead, this position will… more
- Mount Sinai Health System (New York, NY)
- …minimum of 3 years coding experience o At least 1 year of HCC Risk Adjustment experience, preferred o Clinical background in a healthcare setting, preferred ... the following, required: o Certified Coding Specialist (CCS) o Certified Risk Adjustment Coder (CRC) o Certified Professional Coder (CPC) Additional Skills and… more
- Molina Healthcare (Lexington, KY)
- … management activities and clinical informatics + Experience with Risk Adjustment Data Validation ** Preferred License, Certification, Association** + Certified ... training and education to network of providers on how to improve their risk adjustment knowledge as well as provide coding updates related to Risk Adjustment … more
- Sanford Health (Worthington, MN)
- …experience. Experience and knowledge of accreditation and regulatory agency standards preferred . Quality, medical coding, and/or risk adjustment experience is ... Will incorporate responsibilities related to the quality risk and risk score adjustment programs. Assist with the quality improvement review and audit related to… more
- EMCOR Group (Alexandria, VA)
- …Knowledge of the principles, practices and techniques of the Navy and Air Force Price Adjustment Guides preferred . + Knowledge of the principles of the Price ... Adjustment clauses of the FAR preferred . + Ability to plan, organize and implement work assignments and work independently on multiple projects. + Ability to… more
- Virginia Mason Franciscan Health (Seattle, WA)
- …an instructor/trainer preferred . + Clinical knowledge and exposure to risk adjustment coding preferred . + Experience with Radiation Oncology coding, ... develops and conducts on-going training regarding professional services and risk adjustment revenue and reimbursement. + Interprets changes in the external… more
- Health First (Rockledge, FL)
- *POSITION SUMMARY * Contribute to Health First Health Plans Risk Adjustment activities that support compliance with regulatory and contractual requirements specific ... responsible for assisting leadership with daily operations pertaining to Risk Adjustment operational activities including but not limited to: executing training for… more
- Evolent Health (Columbus, OH)
- …for the mission. Stay for the culture. **What You'll Be Doing:** The **Risk Adjustment HCC Coding Support Specialist** at Evolent will be an intricate part of the ... Risk Adjustment coding team. Coding for MSSP, MA and Commercial...or management of conditions is required. A bachelor's degree preferred (Other college degree's will be considered.) Certification as… more
- CareFirst (Baltimore, MD)
- …+ RHIT - Registered Health Information Technician or RHIA Upon Hire Preferred **Experience:** 3 years risk adjustment /hierarchical condition category (HCC) ... **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Specialist supports the retrospective risk adjustment supplemental filing, HHS-Risk … more
- Centene Corporation (Tallahassee, FL)
- …audits, analysis of practice coding patterns, education and training regarding risk adjustment to ensure accurate CMS payment and improve quality of care. Analysis ... market level. + Subject matter experts for proper risk adjustment coding and CMS data validation + Work in...an educator/instructor role required; but provider education experience is preferred * Preferred managed care experience **REQUIRED… more
- UCLA Health (Los Angeles, CA)
- Description As the Medicare Advantage Risk Adjustment Provider Documentation Trainer and Auditor, 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 plan. You will: + Conduct medical record audits for… more
- CenterWell (Carson City, NV)
- …caring community and help us put health first** The Associate Director, Risk Adjustment oversees quality assurance audits of medical records, ICD-10-CM, CPT, & HCPCS ... and over government agencies. In addition, the Associate Director, Risk Adjustment oversees all medical coding education activities. The Associate Director, Risk… more
- Fallon Health (Worcester, MA)
- …on FCHP patient charts for the purpose of validating regulatory Risk Adjustment scores. The Chart Review Specialist will collect diagnostic details and documentation ... feedback and submit to Manager for provider education efforts + Update risk adjustment software with all relevant chart review observations + Meet or exceed daily… more
- Molina Healthcare (Columbus, OH)
- **Job Description** **Job Summary** The AVP, Quality & Risk Adjustment is responsible for leading health plan execution for Risk Adjustment and Quality for all ... ensuring alignment of strategy and activities with Enterprise, acting as the Risk Adjustment and Quality subject matter expert for the health plan. The AVP leads… more
- Martin's Point Health Care (Portland, ME)
- …since 2015. Position Summary **NEW REMOTE POSITION** The Senior Risk Adjustment Analyst analyzes data, reviews findings, and develops recommendations for leadership ... used in complex conceptual analyses for all departments within Risk Adjustment Operations + Develops systematic reporting processes and procedures to ensure… more
- Henry Ford Health System (Troy, MI)
- …RHIT, CPC, CRC, CCS) required. + 1 or more years' experience in HCC/Risk Adjustment preferred . + Knowledge of ICD-10 and HCC coding guidelines. + Exemplary ... organizational and communication skills. + Ability to build relationships, negotiate processes and outcomes, and influence behaviors. + Knowledge of health care fiscal management goals and strategies, including but not limited to trends and issues in health… more