- Humana (Santa Fe, NM)
- …understanding of how organization capabilities interrelate across the function or segment. The Risk Adjustment Director of Compliance ensures compliance with ... more
- Marshfield Clinic (Marshfield, WI)
- …come together to support the most exciting missions in the world!** **Job Title:** Director of Actuarial and Risk Adjustment Services **Cost Center:** ... more
- BlueCross BlueShield of North Carolina (NC)
- …Arrangements (ACO/CIO) and Medicare Quality Initiatives (Stars and Risk Adjustment ). + Excellent presentation, communication and relationship building ... more
- CareOregon (Portland, OR)
- …Exemption Status Exempt Management Level Manager Direct Reports Coding Auditors Manager Title Director , Risk Adjustment Pay and Benefits Estimated hiring ... 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 ... more
- Mount Sinai Health System (New York, NY)
- …adjustment with a group of practices and (2) close partnership with the CDQI Director to drive accurate risk adjustment throughout the system. This ... more
- WelbeHealth (Los Angeles, CA)
- …Python, R), Excel, and financial modeling tools + Deep understanding of CMS risk adjustment , Medicaid rate-setting, and Medicare Advantage/Part D payment ... more
- CenterWell (Pierre, SD)
- …+ Ability to travel up to 20% **Preferred Qualifications** + Proven experience with Medicare Advantage risk adjustment functions. + Proven track record of ... more
- CVS Health (Aurora, CO)
- …+ Utilization Management + Network Management + Health Plan Management + Documentation/ Risk Adjustment + Clinical Compliance & Policy Development + This ... more
- Molina Healthcare (Omaha, NE)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... more
- Bristol Myers Squibb (Washington, DC)
- …every treatment we pioneer. Join us and make a difference. **Position Summary** The Director , 340B Policy Strategy, will serve as a deep technical expert in the ... more
- CVS Health (Chicago, IL)
- …health, transitions-in-care, pharmacy and medication adherence, HEDIS / Stars, accurate risk adjustment , preferred partner relationships, and remote monitoring. ... more
- Elevance Health (Nashville, TN)
- …and engages appropriate resources for solution. + Collaborates with Care Consulting, Pharmacy, and Risk Adjustment teams to drive Cost of care and HEDIS Star ... more
- CVS Health (Des Moines, IA)
- …to, transitions-in-care, pharmacy and medication adherence, HEDIS / Stars, accurate risk adjustment , preferred partner relationships, and patient engagement ... 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- ... 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- ... more
- CareOregon (Portland, OR)
- …# 24856 Exemption Status Exempt Management Level n/a Direct Reports n/a Manager Title Director Risk Adjustment Department Finance Pay and Benefits Estimated ... more
- CenterLight Health System (NY)
- …on current performance. + Serves as a subject matter expert on Risk Adjustment Data Validation (RADV) audits from Medicare . + Perform random audits of coding ... more
- VNS Health (Manhattan, NY)
- …reimbursement related issues; makes coding and documentation recommendations for adherence to risk adjustment models. + Reviews medical documentation to ensure ... more
- Molina Healthcare (Owensboro, KY)
- …quality and risk adjustment VPs, Regional Directors of Quality/ Risk , Director of Value Based Programs, medical economics/actuaries and local health ... more
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