- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
- 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 (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
- 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
- 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
- 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
- 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
- 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
- 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
- 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
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