- Ankura (New York, NY)
- …Risk Adjustment data collection and submission activities as well as knowledge of Risk Adjustment coding requirements preferably with a Risk ... and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment . The Senior Director will also support practice… more
- CenterWell (Tallahassee, FL)
- … leaders/coders) + Partner with MRA Strategy and Analytics teams to establish risk adjustment analytics to identify coding improvement opportunities, ... caring community and help us put health first** The Director , Medical Coding extracts clinical information from...function or segment. **Strategy:** + In partnership with AVP, Risk Adjustment and AVP, MRA Strategy, responsible… more
- Point32Health (Canton, MA)
- …with our corporate and business division goals. This position will report to the Director of Risk Adjustment Strategy, Operations and Quality Assurance. ... Point32Health (https://www.point32health.org/) . **Job Summary** This position will lead the Risk Adjustment Operations & Provider Consulting team responsible… more
- Henry Ford Health System (Detroit, MI)
- …to maximize accurate reimbursement. + Support initiatives for quality reporting, risk adjustment , provider education, and regulatory compliance. Innovation, ... and ensuring the financial strength of our system. As the Director of Procedural and Anesthesia Coding , you'll set the strategy and lead system-wide efforts to… more
- St. Mary's Healthcare (Amsterdam, NY)
- …Demonstrated knowledge of ICD-10-CM/PCS, CPT/HCPCS coding , MS-DRGs, APR-DRGs, APCs, and risk adjustment . Certifications / Licensure: + RHIA, RHIT, or CCS ... factors permitted by law. Responsibilities: + Provide day-to-day leadership to coding teams across inpatient, outpatient and professional services. + Partner with… more
- Datavant (Topeka, KS)
- …and prospects. + Serve as a trusted advisor, demonstrating a strong understanding of risk adjustment , HCC coding , and value-based care operations. + Liaison ... **What We're Looking For** We are seeking an experienced Director of Risk Bearing Provider Sales to...in complex healthcare environments. + Deep understanding of **HCC coding , chart retrieval, risk adjustment … more
- Emanate Health (Covina, CA)
- …Plan partners, MSO personnel, physicians, and billing staff to ensure accurate documentation, coding compliance, and optimal risk adjustment outcomes. The ... HCC Coding Specialist ensures the IPA's Risk Adjustment Factor (RAF) maintains or exceeds 1.0 and supports achieving or improving a 4.0 STAR Rating or… more
- HCA Healthcare (Nashville, TN)
- … coding and documentation improvement education to Providers. + Assists the Director Coding Operations Division Support in reviewing progress against business ... (CPC(R)) credential or Certified Professional Coder - Hospital (CPC-H(R)) or Certified Risk Adjustment Coder (CRC) **EXPERIENCE:** + Experience with Cerner and… more
- Penn Medicine (Bala Cynwyd, PA)
- … coding medical professional services experience including ambulatory outpatient and risk adjustment coding (Required) + Additional experience could ... Cynwyd** **Hours: Full-Time, Per Departmental Needs** **Job Summary:** The Ambulatory Coding and Documentation Specialist reports to the Primary Care Service Line,… more
- Scripps Health (San Diego, CA)
- …of ICD, CPT, and HCPCS coding systems, MS-DRG/APR-DRG methodologies, and risk adjustment /HCC principles. * Strong technical proficiency and experience in ... *This Senior Director position is eligible to participate in the...Documentation Integrity*provides strategic leadership and operational oversight for systemwide Coding , Clinical Documentation Integrity (CDI), and Health Information Management… more
- Wolters Kluwer (Philadelphia, PA)
- …content-including value sets and clinical decision support (CDS) rules-to enable risk adjustment suspect identification, recapture workflows, and prior ... maintain clinical terminology assets (value sets, mappings, hierarchies) for risk adjustment workflows. + Develop CDS and...CDS and documentation rules to guide providers toward accurate coding and documentation for HCCs and other risk… more
- Beth Israel Lahey Health (Charlestown, MA)
- …a strong understanding of case mix index, MCC/CC capture, the severity of illness/ risk of mortality, LOS, risk adjustment diagnoses. * Participate ... the Beth Israel Lahey Health (BILH) Vice President, Mid-Revenue Cycle, the Director of Clinical Document Improvement (CDI) is primarily responsible for managing all… more
- Ankura (VA)
- …claims processing and payment, provider contracts, market pricing, benefits administration, billing and coding , risk adjustment , etc. + Expand and build new ... in emerging healthcare topics driving the industry like predictive analytic applications, risk adjustment , and value-based care. + Develop, supervise, and… more
- Amazon (Mountain View, CA)
- …with business teams on science-heavy problems, incubating products with high AI research risk , reducing friction and manual effort with AI tooling, and raising the ... Mathematics). - Experience in industry, consulting, government, or academic research. - Coding ability in a scripting language such as R, Python, Matlab, or… more
- HCA Healthcare (Campbell, CA)
- …or face-to-face setting within physician practices. The CDI Specialist, Outpatient will utilize risk adjustment coding expertise to educate providers and ... TO:** + Reviews patient medical records to identify clinical documentation improvement opportunities for risk adjustment coding . + Provides coding and… more
- Hartford HealthCare (Farmington, CT)
- …observed to expected ratio (O:E), capture of appropriate severity of illness (SOI) and risk of mortality (ROM), risk adjustment and hierarchal condition ... work in collaboration with the clinical documentation specialists (CDS), coding professionals, providers, nursing staff and other patient care...capture (HCC) codes, risk adjustment , and other high quality documentation outcome measures. .… more
- Good Samaritan (Sioux Falls, SD)
- …and knowledge of accreditation and regulatory agency standards preferred. Quality, medical coding , and/or risk adjustment experience is preferred. Currently ... of the assigned area(s) of nursing. Will incorporate responsibilities related to the quality risk and risk score adjustment programs. Assist with the quality… more
- New York State Civil Service (Menands, NY)
- …this critical service at any time.Under the direction of the Assistant Director of Information Technology Services (ADITS1), M-4, within the Dedicated Support ... across all projects, ensuring alignment with application design principles, coding standards, accessibility guidelines, and quality benchmarks.* QA Strategy &… more
- Point32Health (NH)
- …claims data, coding schemes (ICD-9/ICD-10, CPT/HCPCS, DRGs), and health status risk adjustment . In-depth health care reimbursement and managed care business ... . **Job Summary** Working under the direction of the Director or Senior Manager, the Senior Network Performance Analyst...and Reserving to ensure open communication relating to provider risk deals. + In-depth knowledge and understanding of managed… more
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