- Elevance Health (Norfolk, VA)
- ** Risk Adjustment Advanced Analyst Senior** **Location: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 ... one of our Elevance Health PulsePoint locations.** **Preferred Location: Norfolk, VA.** The ** Risk Adjustment Advanced Analyst Senior** is responsible for… more
- System One (Houston, TX)
- …years of management experience strongly preferred. + Experience with various risk adjustment models including the CMS Medicare model, CMS ACA Model and 3rd ... responsible for risk score tracking and improvement. + Maintains internal risk adjustment models using published documentation. + Manages projects including… more
- LA Care Health Plan (Los Angeles, CA)
- …skills Preferred: Knowledge of managed care and health care claims Knowledge of Risk Adjustment models (eg CMS Medicare Advantage, HHS-HCC, Medicaid ... Manager, Analytics Job Category: Accounting/Finance Department: Risk Adjustment Strategies & Initiatives Location: Los Angeles, CA, US, 90017 Position Type: Full… more
- CVS Health (Overland Park, KS)
- …Medicare Advantage, MSSP, ACO REACH).** **What will you do?** + Evaluate the impact of Medicare quality and risk adjustment program has on our MA risk ... partners and ACOs through the use of actuarial and advanced analytics techniques + Proactively identify areas of opportunities...Medicare claims dataset -Ability to conduct actuarial and risk adjustment (CMS-HCC) analysis -Excellent oral &… more
- Elevance Health (Seven Fields, PA)
- **JR127301 Business Consultant Sr (Operational)** The Sr. Business Consultant will support the Advanced Primary Care risk adjustment team through vendor ... have a healthcare background with a strong understanding of Risk Adjustment . You should have experience in...adjustment and/or health insurance industry. + Experience in Medicare Advantage and Medicaid in a provider based or… more
- AdventHealth (Overland Park, KS)
- …communities of southeastern Johnson County, with 24/7 emergency room services, an advanced imaging center, physical therapy and more. **The role you'll contribute:** ... coordinates and facilitates the development of a discharge plan of care for high- risk patient populations. This role will receive referrals for individuals from at-… more
- AdventHealth (Hinsdale, IL)
- …coordinates and facilitates the development of a discharge plan of care for high- risk patient populations. This role will receive referrals for individuals from at- ... risk populations from interdisciplinary team members (including physicians, RN Care Managers, staff nurses, and other members of the care team). The Social Work Care… more
- AdventHealth (Bolingbrook, IL)
- …coordinates and facilitates the development of a discharge plan of care for high- risk patient populations. This role will receive referrals for individuals from at- ... risk populations from interdisciplinary team members (including physicians, RN...substance use and addictive disorders o Provides patient/family education, adjustment -to-illness counseling, grief counseling and crisis intervention o Provides… more
- AdventHealth (Shawnee, KS)
- …coordinates and facilitates the development of a discharge plan of care for high- risk patient populations. This role will receive referrals for individuals from at- ... risk populations from interdisciplinary team members (including physicians, RN...substance use and addictive disorders + Provides patient/family education, adjustment -to-illness counseling, grief counseling and crisis intervention + Provides… more
- reveleer (OH)
- …8-10+ years' experience in a customer-facing account or vendor management role, managing Risk Adjustment projects specific to Medicare , Medicaid, and ... fast-growing technology-enabled services company that powers performance/quality measurement and risk adjustment solutions in healthcare. Specifically, Reveleer… more
- New York State Civil Service (Bedford Hills, NY)
- …counseling, etc. Duties Description Associate Psychologist functions as an advanced clinician and provide professional psychological services under the clinical ... substance and/or chemical abuse programs, specialized assessment (functional, personality, risk , competency, vocational, education); design and application of behavioral… more
- Intermountain Health (Las Vegas, NV)
- …physicians, advanced practice providers (APP), and other staff about documentation and risk adjustment in order to improve the accuracy of the overall ... mentor to leaders, physicians, APP's, and other staff about documentation and risk adjustment . + Reviews medical records documentation for reimbursement,… more
- Novant Health (NC)
- …Quality, Total Cost of Care, Network Integrity, Social Determinants of Health, Risk Adjustment , and Attribution. + Build compelling visualizations, innovative ... performance opportunity identification. + Maintain a working knowledge of Medicare , Medicaid, and commercial insurance products and value-based care incentive… more
- AdventHealth (Apopka, FL)
- …health care facility. From critical care to specialized emergency medicine and advanced diagnostic imaging, we provide a multitude of inpatient and outpatient ... offer services from emergency to radiology, robotic surgery to advanced specialty care with the recent expansion of our...of health into transitions of care planning and applies risk mitigation interventions to meet the individual needs of… more
- St. Luke's University Health Network (Easton, PA)
- …patient as healthy as possible in the outpatient setting, minimizing the risk of readmissions. + Issues applicable state/federal regulatory notices as applicable ... ie.) Important Message from Medicare (IMM), Medicare Outpatient Observation Notice (MOON),...(MOON), Bundle Payment Care Initiative (BPCI) notification. + Monitors risk assessment using available tools and implements discharge interventions… more
- University of Virginia (Charlottesville, VA)
- …large-scale complex initiatives, focusing on QI, Medicare Star Ratings, HEDIS and Risk Adjustment . + Prepare implement and monitor regional work plans to ... trainings on priority HEDIS quality measures, complex diagnosis documentation for improved risk adjustment , and best practice EPIC workflows to ensure patient… more
- Commonwealth Care Alliance (Boston, MA)
- …+ Maintain current industry knowledge of highly impactful external audits such as Risk Adjustment Data Validation Audit, CMS Program Audit protocols, common ... + Contribute towards the maintenance and enhancement of an effective Compliance Risk Assessment Program + Project manage regulator and other external reviews as… more
- New York State Civil Service (Thiells, NY)
- …program, may be substituted for one year of the required experience. Certificate of advanced study in a clinical field of psychology or school psychology may be ... and monitor functional behavior assessments and behavior support plans (or higher- risk behavior support plans for anyone with forensic background) for individuals… more
- Virginia Mason Franciscan Health (Silverdale, WA)
- …the Masters Social Worker include: crisis intervention, patient/family intervention, high- risk screening, brief counseling, referrals for financial or other ... discharges and engagement of appropriate agencies or community resources when high- risk patients are identified. ESSENTIAL KEY JOB RESPONSIBILITIES 1. Providing… more
- Virginia Mason Franciscan Health (Silverdale, WA)
- …the Masters Social Worker include: crisis intervention, patient/family intervention, high- risk screening, brief counseling, referrals for financial or other ... discharges and engagement of appropriate agencies or community resources when high- risk patients are identified. ESSENTIAL KEY JOB RESPONSIBILITIES 1. Providing… more