• Certified Risk Adjustment

    Trinity Health (Livonia, MI)
    **Employment Type:** Full time **Shift:** **Description:** **CERTIFIED RISK ADJUSTMENT CODING SPECIALIST** **Location:** Trinity Health PACE Corp Michigan ... client care documentation for billing. + Monitors and informs manager of records that are not completed timely. Monitors,...year if hired. + Two-years of experience in a risk adjustment coding environment required.… more
    Trinity Health (10/26/24)
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  • Risk Adjustment Provider Educator…

    The Cigna Group (Houston, TX)
    …(CCS-P) + Registered Health Information Management Technician (RHIT) + 5+ years of risk adjustment coding experience, 3+ national Medicare Advantage health ... will work under the direction of Risk Adjustment & Stars Provider Education Regional Manager ...matrix partners of Cigna Medicare's programs specific to CMS Risk Adjustment and HCC Coding more
    The Cigna Group (11/14/24)
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  • Associate Director, Risk Adjustment

    CenterWell (Tallahassee, FL)
    …(CMS), other payers, and over government agencies. In addition, the Associate Director, Risk Adjustment oversees all medical coding education activities. The ... understanding of how organization capabilities interrelate across departments. The Associate Director, Risk Adjustment ensures coding is accurate and… more
    CenterWell (10/30/24)
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  • Quality and Risk Adjustment

    Premera Blue Cross (Mountlake Terrace, WA)
    …training is available for documentation and coding best practices for HEDIS and risk adjustment . This role will have a positive impact on our clinical ... strategies to influence provider behavior. + Educate and communicate concepts related to risk adjustment , documentation, and coding best practices. Partner… more
    Premera Blue Cross (11/13/24)
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  • Coding Manager - Remote

    Trinity Health (Livonia, MI)
    **Employment Type:** Full time **Shift:** Day Shift **Description:** **Certified Medical Coding Manager - Remote** **Location:** Trinity Health PACE Corp ... to 330 pm Eastern **Position Purpose:** The Certified Medical Coding Manager oversees the Coding ...Clinical Documentation & HIM to analyze the quarterly Semi-Annual Risk Adjustment Reporting Suite and develop strategies… more
    Trinity Health (11/16/24)
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  • Program Manager , Professional…

    Beth Israel Lahey Health (Wakefield, MA)
    …opportunities, supporting day to day issues, and monitoring performance related to acuity/ risk adjustment . This will involve high levels of collaboration, ... projects and performance improvements initiatives that support clinical documentation improvement/acuity/ risk adjustment , including, but not limited to pilot… more
    Beth Israel Lahey Health (11/03/24)
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  • Sr Coding Compliance Auditor

    Catholic Health Initiatives (Chattanooga, TN)
    …and committees as appropriate. + Reports areas of risk directly to the Coding Integrity Manager /Supervisor. + Maintains a high level of competency related to ... team to support the needs of the organization. The position will support risk adjustment improvement efforts across the medical group. The Hierarchical Condition… more
    Catholic Health Initiatives (10/25/24)
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  • Hybrid Coding Educator

    Healthfirst (NY)
    …+ Acts as a resource on coding issues and questions to ensure accurate coding for appropriate Risk Adjustment data capture for inpatient and outpatient. ... coding practices and case-mix index, including areas of risk and comparing coding profiles with national...action plans and reports results of follow-up audits to Coding Manager and AVP. + Maintains statistics… more
    Healthfirst (10/19/24)
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  • Onsite Coding Auditor, SAMF Admin CBO…

    Trinity Health (Fresno, CA)
    …Trinity practices and policies. Partners with leadership to improve HCC and other Risk Adjustment capture with provider and coder education. Conducts ongoing ... **Employment Type:** Full time **Shift:** Day Shift **Description:** Reporting to the Manager Medical Group Revenue Cycle Site Operations, Fresno, this position is… more
    Trinity Health (10/02/24)
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  • Outpatient Clinical Documentation Integrity (CDI)…

    Fairview Health Services (St. Paul, MN)
    …provider documentation for clinical conditions and procedures to reflect severity of illness, risk adjustment , accurate coding , accuracy of patient outcomes, ... the impact of documentation on patient care, quality metrics, risk adjustment , and correct reimbursement. Adheres to.... + May provide educational support in terms of clinical/ coding or process at manager 's discretion and… more
    Fairview Health Services (11/16/24)
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  • Cell Therapy Market Access Manager

    Bristol Myers Squibb (New Orleans, LA)
    …. **Summary:** The Cellular Therapy (CAR T) Market Access Manager (CMAM) is responsible for executing access and reimbursement strategies ... policy, local payer dynamics and coverage policy, complex reimbursement, coding & billing dynamics, and all components of the...by your state of residence, and 3) a driving risk level deemed acceptable by the Company. \#LI-Remote If… more
    Bristol Myers Squibb (11/17/24)
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  • Clinical Manager

    BronxCare Health System (Bronx, NY)
    Overview The Nurse Manager is responsible on the night shift (4 ten hour shifts), for quality and safety of outcomes consistent with the philosophy and goals of the ... insttitution. The Nurse Manager facilitates employee and patient satisfaction through professional oversight. Responsibilities 1. CUSTOMER PATIENT FOCUS * Establish… more
    BronxCare Health System (09/18/24)
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  • Finance Manager

    reveleer (Los Angeles, CA)
    …plans across all business lines greater control over their Quality Improvement, Risk Adjustment , and Member Management programs. With one transformative ... Finance Manager Onsite - Glendale, CA Reveleer is a...every aspect of enrollment, provider outreach and data retrieval, coding , abstraction, reporting, and submissions. Leveraging proprietary technology, robust… more
    reveleer (10/24/24)
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  • Manager Analytics, IHCI

    Community Health Network (Indianapolis, IN)
    …model. We are searching for candidates with experience with medical economics, risk adjustment , quality reporting, and/or clinical stratification. The individual ... Manager Analytics, IHCI Job Ref 2406244 Category Leadership...stakeholders is required. + 3 or more years of coding skills in multiple programming languages, including experience with… more
    Community Health Network (09/14/24)
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  • Complex Coder Physician Practice General Medicine

    Banner Health (AZ)
    …career here! **Bring your years of Multi-Specialty - General Medicine (some HCC) Coding ** **experience** with Certified Risk Adjustment Coder (CRC) ... **Primary City/State:** Arizona, Arizona **Department Name:** Coding Ambulatory **Work Shift:** Day **Job Category:** Revenue...of 10 remote coders, who report to 1 Associate Manager ; 1 Associate Director. As a team member, you… more
    Banner Health (09/21/24)
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  • Diagnosis Related Group Auditor

    Hackensack Meridian Health (Hackensack, NJ)
    …+ Reviews CDI quality liaison recommendations as it relates to mortality, PSI/HAC, POA and risk adjustment codes and makes changes as needed in compliance with ... for CMS. The DRG auditor is responsible for ensuring coding accuracy, coding consistency and efficiency in...on a quarterly basis. + Provides feedback to CDMP Manager regarding CDMP nurses for performance evaluation purposes. +… more
    Hackensack Meridian Health (09/06/24)
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  • Manager , Clinical Quality Analytics

    LA Care Health Plan (Los Angeles, CA)
    …Experience Required: At least 6 years of experience in HEDIS, quality improvement, risk adjustment analytics, research, or related work within a healthcare ... Manager , Clinical Quality Analytics Job Category: Clinical Department:...payment concepts and related engagement strategies. Knowledge of SQL coding . Knowledge of managed care concepts and principles and… more
    LA Care Health Plan (08/28/24)
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  • Network CDI Team Lead

    WMCHealth (Valhalla, NY)
    …Responsibilities: + Conducts New CDI Specialist Onboarding & Education, + Perform Staff risk adjustment audits, track and review findings and trends + Assists ... Improvement Lead Specialist demonstrates excellent problem-solving, clinical knowledge, and coding knowledge requirements to support and improve the overall quality… more
    WMCHealth (10/30/24)
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  • Medicare Provider Performance Enablement Lead…

    The Cigna Group (Sunrise, FL)
    …on topics including, but not limited to: preventative and quality outcome metrics, risk adjustment , medical cost management, etc. + Schedules, prepares for and ... including but not limited to Health Services, Medical Economics, Sales, and Sales & Risk Adjustment in order to develop solutions for strategic business needs +… more
    The Cigna Group (10/03/24)
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  • Medicare Provider Performance Enablement Lead…

    The Cigna Group (Seattle, WA)
    …on topics including, but not limited to: preventative and quality outcome metrics, risk adjustment , medical cost management, etc. + Schedules, prepares for and ... including but not limited to Health Services, Medical Economics, Sales, and Sales & Risk Adjustment in order to develop solutions for strategic business needs… more
    The Cigna Group (10/26/24)
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