• Business Change Director - Risk

    Elevance Health (Atlanta, GA)
    **Business Change Director - Risk Adjustment Data Quality** **Location:** This position will work a hybrid model (remote and office). Ideal candidates must ... live within 50 miles of a PulsePoint location. The **Business Change Director for Risk Adjustment Data Quality** will serve as a strategic partner for the… more
    Elevance Health (11/02/24)
    - Save Job - Related Jobs - Block Source
  • Associate Director , Risk

    CenterWell (Tallahassee, FL)
    …a part of our caring community and help us put health first** The Associate Director , Risk Adjustment oversees quality assurance audits of medical records, ... (CMS), other payers, and over government agencies. In addition, the Associate Director , Risk Adjustment oversees all medical coding education activities. The… more
    CenterWell (10/30/24)
    - Save Job - Related Jobs - Block Source
  • Senior Director , Medicare Risk

    Somatus (Mclean, VA)
    …physical and mental well-being + Community engagement opportunities + And more! The Sr. Director , Medicare Risk Adjustment (MRA) will lead the execution ... strategy and implementation of the organization's Risk Adjustment Programs to optimize the programs' clinical benefit, financial accuracy and ensure program… more
    Somatus (10/09/24)
    - Save Job - Related Jobs - Block Source
  • Medical Director Physician Engagement…

    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 ... the status quo **Role Summary:** MSHP seeks a Medical Director (MD), Physician Engagement and CDQI, who will (1)...drive excellence in efficiency of care, quality and accurate risk adjustment for all populations served, especially… more
    Mount Sinai Health System (09/02/24)
    - Save Job - Related Jobs - Block Source
  • Risk Adjustment Education Specialist…

    Carle (Urbana, IL)
    Risk Adjustment Education Specialist - HYBRID +...Medical Director to strategically plan and execute Risk Adjustment coding efforts for accuracy and ... None Email a Friend Save Save Apply Now Position Summary: The Risk Adjustment Education Specialist consults with providers and their office staff on a… more
    Carle (09/10/24)
    - Save Job - Related Jobs - Block Source
  • Business Strategy Planning Director

    Elevance Health (Wilmington, DE)
    …must live within 50 miles of a PulsePoint location. The **Business Strategy Plan Director -Use Case Lead for Risk Adjustment ** is responsible for ... **Business Strategy Planning Director - Risk Adj. Use-Case Lead** **Location:** This...data (HealthOS) assets to drive downstream use cases for Risk Adjustment . This role will ensure that… more
    Elevance Health (11/02/24)
    - Save Job - Related Jobs - Block Source
  • HFHP Risk Adjustment Operations…

    Health First (Rockledge, FL)
    …Government Program Director to develop a comprehensive, long-term Medicare risk adjustment strategy. *Stewardship: * * Responsible for coordinating efforts ... by: providing outstanding service by effectively managing and directing the Risk Adjustment department to meet the needs of its internal customers and… more
    Health First (11/07/24)
    - Save Job - Related Jobs - Block Source
  • Risk Adjustment Auditor Educator

    Centene Corporation (Tallahassee, FL)
    …medical record audits, analysis of practice coding patterns, education and training regarding risk adjustment to ensure accurate CMS payment and improve quality ... and market level. + Subject matter experts for proper risk adjustment coding and CMS data validation...include Provider Relations, Quality as well as the Medical Director for the state assigned to ensure compliance of… more
    Centene Corporation (09/25/24)
    - Save Job - Related Jobs - Block Source
  • HCC Risk Adjustment QA Auditor:…

    Providence (Beaverton, OR)
    …best people, we must empower them._** **Providence Health Plan is calling an** HCC Risk Adjustment QA Auditor: Medicare Advantage & ACA **who will:** + Perform ... audits of Hhierarchical Condition category (HCC) coding review for Risk Adjustment staff, contractors, and vendors +...projects + Partner with the coding team, Supervisors, and Director to improve the accuracy, integrity, and quality of… more
    Providence (10/31/24)
    - Save Job - Related Jobs - Block Source
  • Staff VP Compliance Medicare Operations…

    Elevance Health (Atlanta, GA)
    …program areas including but not limited to: claims, grievances and appeals, Part D and risk adjustment . + Knowledge of Risk Adjustment Payment ... objectives. + Collaborates with management to set strategic vision; oversees manager(s)/ director (s) with direct reports. + Hires, trains, coaches, counsels, and… more
    Elevance Health (11/06/24)
    - Save Job - Related Jobs - Block Source
  • Director , Modeling Risk

    KPMG (Boston, MA)
    **Business Title:** Director , Modeling Risk **Requisition Number:** 118221 - 40 **Function:** Advisory **Area of Interest:** **State:** MA **City:** Boston ... a career in Advisory. KPMG is currently seeking a Director , Modeling Risk in Market, Credit, &...and calculations for market risk , counterparty credit risk and credit valuation adjustment + Build… more
    KPMG (10/18/24)
    - Save Job - Related Jobs - Block Source
  • Regional Director , Risk & Quality…

    Molina Healthcare (UT)
    **JOB DESCRIPTION** **Job Summary** Regional Director Risk & Quality Solutions is responsible for contributing to the strategic performance improvement direction ... engagement teams within Molina. + Possesses a strong knowledge in risk adjustment programs and processes, data acquisition processes, HEDIS and quality… more
    Molina Healthcare (11/07/24)
    - Save Job - Related Jobs - Block Source
  • Director , Value-Based Programs (New Mexico…

    Molina Healthcare (Albuquerque, NM)
    …related to activities in all government lines of business impacted by regulatory risk adjustment payment model. Accountable for designing and implementing a ... lead to the overall achievement of improved accuracy, compliancy, and completeness in risk adjustment revenue for all government lines of business. Supports the… more
    Molina Healthcare (10/11/24)
    - Save Job - Related Jobs - Block Source
  • Executive Director , Aetna IFP Finance

    CVS Health (Hartford, CT)
    …this dynamic business that could be aligned with membership, revenue, SG&A and risk adjustment . You will collaborate with stakeholders to align financial goals ... Plans Finance team is looking for a creative Executive Director who will build a Center of Excellence team...example functions include Finance, Actuarial, Product and Pricing, Network, Risk Adjustment Operations. + Manage senior stakeholders… more
    CVS Health (10/26/24)
    - Save Job - Related Jobs - Block Source
  • Director , Strategic Development

    BP Americas, Inc. (Houston, TX)
    …Family Group:** Business Support Group **Job Description:** **Job Description - Director , Strategic Development** **Summary** The Director , Strategic Development ... **status. Individuals** **with an accessibility need may request an** ** adjustment /accommodation** **related to bp's recruiting process (eg, accessing the job… more
    BP Americas, Inc. (10/31/24)
    - Save Job - Related Jobs - Block Source
  • Associate Director , Project Management

    Mitsubishi Chemical Group (Jersey City, NJ)
    …on real-world evidence, and creating hope for all facing illness. The Associate Director , Project Management is an integral member of the Product Development Teams ... Development Strategy. As a senior, highly experienced team member, the Associate Director , Project Management is responsible for monitoring the execution of the Drug… more
    Mitsubishi Chemical Group (08/16/24)
    - Save Job - Related Jobs - Block Source
  • Associate Director , Compliance and Ethics…

    Bristol Myers Squibb (Princeton, NJ)
    …Development Organizations . In this role, you will combine your knowledge about risk mitigation strategies , such as education and monitoring, with data analytics ... about executional risk to help the business make well-informed, risk...their decisions. + Under the direction of the Senior Director , US and Above Market Medical and Market Access… more
    Bristol Myers Squibb (11/03/24)
    - Save Job - Related Jobs - Block Source
  • Director , Wholesale Marketing

    Tucson Electric Power (Tucson, AZ)
    ** Director , Wholesale Marketing** Company **Tucson Electric Power** Location **Tucson, AZ** Requisition ID **5672** **About Us** UNS Energy Corporation ... our employees,here (https://youtu.be/hpknvJPLuoc) andhere (https://youtu.be/7BECywu-Re4) . **Job Description - Director , Wholesale Marketing** **Position Description** Responsible for the oversight… more
    Tucson Electric Power (09/12/24)
    - Save Job - Related Jobs - Block Source
  • Director , Project Management (Late…

    Bristol Myers Squibb (Cambridge, MA)
    …more teams including definition of the operational strategy, management of timelines, budget, risk assessment and mitigation. The Director PM works to ensure ... Summary** The KarXT R&D team is looking for a Director Project Manager (PM) to lead indication focused Sub-GPTs...program operational strategy, management of timelines, budget, quality, and risk assessment and mitigation. + The PM will collaborate… more
    Bristol Myers Squibb (10/23/24)
    - Save Job - Related Jobs - Block Source
  • Property Claims Manager (State Risk

    Louisiana Department of State Civil Service (Baton Rouge, LA)
    …damages and uninsured damages if disaster is Presidentially-declared * Provides recommendation to State Risk Director , State Risk Assistant Director and ... Property Claims Manager (State Risk Adjuster 6) Print (https://www.governmentjobs.com/careers/louisiana/jobs/newprint/4717187) Apply  Property Claims Manager (State… more
    Louisiana Department of State Civil Service (11/05/24)
    - Save Job - Related Jobs - Block Source