- Mount Sinai Health System (New York, NY)
- …for driving key population health goals including access, quality, utilization and accurate risk adjustment with a group of practices and (2) close partnership ... with the CDQI Director to drive accurate risk adjustment throughout the system. This Medical Director must be effective at influencing physicians, medical… more
- Universal Health Services, Inc. (Edinburg, TX)
- …Care Resources. Collaborate with our physicians to educate on proper coding, risk adjustment metrics, capture documentation, and follow quality protocols. ... Interview patients to ensure proper documentation and that all preventative screenings have been completed. Join our collaborative team delivering patient-centered primary care across the lifespan in the vibrant Rio Grande Valley. Send CV to ###@uhsinc.com more
- Sanitas Medical Center (Fort Lauderdale, FL)
- …and physician assistants. Ensure completion of HEDIS and quality metrics, appropriate risk adjustment coding , and care coordination. Oversee performance ... improvement initiatives and participate in peer review processes. Support recruitment, onboarding, and professional development of medical providers. Maintain compliance with OSHA, ACHA, infection control , and emergency preparedness standards. Handle complex… more
- Monogram Health (Fort Myers, FL)
- …NCQA, HEDIS, Medicaid, Medicare, quality improvement, medical utilization management, and risk adjustment Current state medical license without restrictions to ... practice and free of sanctions from Medicaid or Medicare. Willingness to become licensed in multiple states. MD (Medical Doctor) or DO degree from an accredited medical school BC or BE in an ACGME approved specialty such as Nephrology, Internal Medicine,… more
- Wisconsin Community Services (Waukesha, WI)
- …participants as required:Predisposition Investigation, Treatment Plan, Treatment Plan Adjustment , Adjustment Summary, Discharge/Transition Plan as well ... other treatment team members. Maintain safety practices and continually assess potential risk when in the community and when working with participants. Coordinate… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Medicare Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and ... integrity of key risk adjustment performance metrics through coordination of analytical processes, investigation and interpretation of CMS risk score… more
- Point32Health (Canton, MA)
- …Point32Health (https://www.point32health.org/) . **Job Summary** This position will lead the Risk Adjustment Operations & Provider Consulting team responsible ... engagement and consultation activities supporting the complete and accurate capture of risk adjustment data. To be successful, the Manager will need to rely on… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Manager plays a critical role in the development and execution of the corporate risk adjustment ... the end to end strategy by applying improvements and driving cost-effective risk adjustment actions across all organizational populations and products.… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Risk Adjustment QA Consultant Location: Hybrid | Eagan, Minnesota Career ... to make a difference, join us. The Impact You Will Have As a Risk Adjustment Quality Assurance (QA) Consultant at BCBSMN, you'll play a critical role in ensuring… more
- Ankura (New York, NY)
- …investigations, and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment . The Senior Director will also support practice ... of activities: + Help clients manage proactive and reactive Medicare and Commercial Risk Adjustment compliance, audit, and investigation projects for clients. +… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Risk Adjustment Business Operations Analyst assumes a pro-active approach in ensuring the accuracy and ... integrity of key risk adjustment performance metrics through coordination of analytical processes, investigation and interpretation of regulated markets risk … more
- Datavant (Honolulu, HI)
- …educational and life experiences to realize our bold vision for healthcare. The Risk Adjustment Sr Data Analyst is an experienced analyst possessing a ... deep understanding of the Risk Adjustment business domain and is skilled at data modeling and analysis and identifying and communicating insights to… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Operations Supervisor supports the execution of the corporate coding strategy across Medicare ... risk conditions from the accurate collection, submission, and validation of risk adjustment data. Ensuring compliance with regulatory standards that ensure… more
- Trinity Health (Albany, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** Risk Adjustment Coding Specialist -St. Peter's Health Partners - Full-time - Remote ... **POSITION PURPOSE:** The Risk Adjustment Coding Specialist works in a team environment and is responsible for reviewing clinical documentation and coding using… more
- Molina Healthcare (Mesa, AZ)
- …DESCRIPTION** **Job Summary** Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintain risk ... identify risks. Additional leadership opportunities are available to lead national risk adjustment studies. Prior experience in Medicaid risk adjustment… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Specialist supports the retrospective risk adjustment supplemental filing, Risk ... and documentation guidelines. The development and ongoing maintenance of the Risk Adjustment Coding guidelines, as well as, guiding junior coding specialists are… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Principal Risk Adjustment Healthcare Analyst Location: Hybrid | Eagan, Minnesota Career ... Blue Shield of Minnesota is hiring a Principal Healthcare Analyst on our Risk Adjustment team in Eagan, MN.The Principal Healthcare Analyst - Risk … more
- Wolters Kluwer (Austin, TX)
- …| Wolters Kluwer (https://www.wolterskluwer.com/en/solutions/health-language)** **Coder Workbench Solution:** ** Risk Adjustment Software | Health Language ... the Eastern or Central time zone, have a solid understanding of risk adjustment in the Healthcare Technology space, experience with Payer, Provider, and Vendor,… more
- Trinity Health (Livonia, MI)
- **Employment Type:** Full time **Shift:** **Description:** **CERTIFIED RISK ADJUSTMENT CODING SPECIALIST** **Location:** Trinity Health PACE Corp Michigan ... thru AHIMA** + **Must be certified or obtaining certification for Certified Risk Adjustment Coder thru AAPC. If not obtaining, must obtain within one year… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Quality & Risk Adjustment Provider Consultant Location: Hybrid | Eagan, Minnesota Career ... experience * Knowledge of Health Care Quality measures * Certified Risk Adjustment Coder (CRC via AAPC) or Certified Professional Coder (CPC via… more
