- UCLA Health (Los Angeles, CA)
- …all this and more at UCLA Health. As member of the Medicare Advantage Risk Adjustment leadership team, the Assistant Director of Risk Adjustment is ... and the manager of coding and education. The Assistant Director of Risk Adjustment will...throughout Southern California. We're also home to the world-class medical research and clinical education capabilities of the David… more
- CVS Health (Columbus, OH)
- …Programs for a portfolio of Aetna Better Health Medicaid Plans. Reporting to the Lead Director of Medicaid Risk Adjustment , the Market Manager will work ... excellence. This position will require a comprehensive understanding of risk adjustment , with the ability to speak...our communities. The Company offers a full range of medical , dental, and vision benefits. Eligible employees may enroll… more
- Point32Health (Canton, MA)
- …individual will be responsible for supporting critical data submission functions for the Risk Adjustment Department (RAD), including submissions to CMS and state ... timely resolution of production issues pertaining to state government and risk adjustment data submissions, including issue investigation, business requirements,… more
- Centene Corporation (Tallahassee, FL)
- … record audits, analysis of practice coding patterns, education and training regarding risk adjustment to ensure accurate CMS payment and improve quality of ... and market level. + Subject matter experts for proper risk adjustment coding and CMS data validation...to include Provider Relations, Quality as well as the Medical Director for the state assigned to… more
- HonorHealth (Scottsdale, AZ)
- …across Arizona. Learn more at HonorHealth.com. Responsibilities Job Summary The Quality & Risk Director will lead and direct the operational quality and ... Medicare Advantage, commercial, and other payers. The Quality & Risk Director will work with ICP's leadership... strategy for solutions and operational activities to improve Risk Adjustment Factor (RAF) scores and associated… more
- RELX INC (Atlanta, GA)
- …and use cases - from credit assessment, to verification, to fraud assessment. The Sr. Director of Strategy for Business Risk Management will serve as the general ... About the business LexisNexis Risk Solutions is the essential partner in the...to offer: * Health Benefits: Comprehensive, multi-carrier program for medical , dental and vision benefits * Retirement Benefits: 401(k)… more
- Mount Sinai Health System (New York, NY)
- …(2) close partnership with the CDQI Director to drive accurate risk adjustment throughout the system. This Medical Director must be effective at ... improve the status quo **Role Summary:** MSHP seeks a Medical Director (MD), Physician Engagement and CDQI,...population health goals including access, quality, utilization and accurate risk adjustment with a group of practices… more
- Evolent (Columbus, OH)
- …including plans related to medical expense management, quality improvement, appropriate risk adjustment , and patient and provider engagement. Members of the ... 10 states and is accountable for over $1B in medical expenses via risk -based relationships with payers...and Network teams. Additionally, the MD will oversee ECP's Risk Adjustment program, with responsibility for developing… more
- ZoomCare (Portland, OR)
- …to become part of our dedicated, fast-moving team of superstars! ZoomCare is seeking a ** Medical Director of Primary Care** to join our team! The Medical ... initiatives. + Strong understanding of healthcare systems, value-based care models, and risk adjustment . + Proven track record of driving change, improving… more
- Molina Healthcare (Columbus, OH)
- …regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare,… more
- Molina Healthcare (Charleston, SC)
- …regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare,… more
- Mitsubishi Chemical Group (Jersey City, NJ)
- …respected - is a research-driven pharmaceutical company that has tirelessly pursued medical breakthroughs with global reach. MTPC has discovered and produced several ... treatments for difficult-to-treat diseases and commercializing products with significant unmet medical needs in North American markets. In the United States, MTPA… more
- Molina Healthcare (Columbus, OH)
- …regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in Utilization/Quality Program… more
- Citigroup (New York, NY)
- …exchanges), credit risk analytics and risk management practice; Credit Value Adjustment risk measuring and risk management; Trading floor market and ... Bank's on-demand queries. Analyze and report business intelligence for Credit Value Adjustment portfolios from perspectives of business, risk , profitability, and… more
- Community Health Network (IN)
- …operational experience with a focus on patient access, quality of care, and risk adjustment while demonstrating leadership, teamwork and effectiveness. The ideal ... development, execution, and communication of key strategic initiatives such as quality, cost, risk adjustment , and patient access. + Coordinate with internal and… more
- Bristol Myers Squibb (Princeton, NJ)
- …single case and aggregate safety monitoring, safety reporting, contribution to benefit- risk assessment, risk management planning and strategy, and execution ... requirements. **Position Summary / Objective** The TA Head - Medical Safety Review provides leadership for Medical ...in their roles. Applicants can request a reasonable workplace accommodation/ adjustment prior to accepting a job offer. If you… more
- Bristol Myers Squibb (Princeton, NJ)
- …single case and aggregate safety monitoring, safety reporting, contribution to benefit- risk assessment, risk management planning and strategy, and execution ... with global regulatory requirements. **Position Summary / Objective** The Head of Medical Safety Review provides leadership and direction for a department of up… more
- Aston Carter (Midland, MI)
- Job Title: Director of Finance Job Description The Director of Finance is a strategic, hands-on manager who leads and develops an internal team to support the ... include complex data analysis and reporting, forecast modeling, budgeting, risk management, development of financial policies and strategy, disbursement of… 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
- Amazon (Seattle, WA)
- Description Scope - Manager, Risk Managers will lead teams which will be responsible for close looping the Executive Escalations (EEs) through a structured Write-up ... process, for Vice President (VP)+ stakeholders. They are expected to navigate between risk , program and product management seamlessly and work with WW program teams… more