- Datavant (Denver, CO)
- …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...growth in complex healthcare environments. Deep understanding of HCC coding , chart retrieval, risk adjustment … more
- Emanate Health (Covina, CA)
- …MSO personnel on HCC and STAR measures related tasks. Responsible to ensure the IPA risk adjustment factor maintains or exceeds 1.0 and achieves or improves upon ... Responsible for the oversight of HCC Program and STAR measures coding related functions. The coding specialist will work with the IPA Director , Health… more
- Molina Healthcare (Omaha, NE)
- …national quality and risk adjustment VPs, Regional Directors of Quality/ Risk , Director of Value Based Programs, and local health plan resources. ... management, strategy, and compliance Knowledge of value based programs, risk adjustment models, quality metrics such as...quality metrics such as HEDIS and STARS, knowledge of coding Knowledge of medical economics and financial reporting. Must… more
- 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
- 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
- Avera (Sioux Falls, SD)
- …and Healthcare Effectiveness Data Information Sets (HEDIS). The Quality and Risk Adjustment Specialist will work closely with the Director of Quality and ... Risk Services, Manager of Risk Adjustment , Manager of Quality, Quality Coordinator...do** + Understand the rationale behind Risk Adjustment Work with physicians, clinic staff, coding ,… 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
- Mount Sinai Health System (New York, NY)
- … coding operations in a multi-entity or academic health system. - Familiarity with risk adjustment , HCC coding , and value-based care models. - Proven ... **Job Description** The Senior Director of Coding is a strategic and operational leader responsible for overseeing all aspects of professional and hospital … 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
- Humana (Salt Lake City, UT)
- …make an impact** **Required Qualifications** + 5+ years of experience in risk adjustment coding /auditing/education and provider relations/engagement + ... gained from actual experience of chronic condition documentation and coding audits, risk adjustment program...+ Cultivate effective partnerships in a matrix environment of coding educators, medical director , clinical and market… more
- Catholic Health Initiatives (Little Rock, AR)
- … for the value hub. + Through Risk Management/Auditor Manager, implements a risk adjustment coding department in appropriate Arkansas and Kentucky CIN. + ... CIN/Population Health Management experience required + Must have experience with risk adjustment coding and value based reimbursement models of payment… more
- HCA Healthcare (Fort Lauderdale, FL)
- … coding and documentation improvement education to Providers. + Assists the Director Coding Operations Division Support in reviewing progress against business ... Coder (CPC(R)) credential or Certified Professional Coder - Hospital (CPC-H(R)) or Certified Risk Adjustment Coder (CRC) EXPERIENCE: + Experience with Cerner and… more
- Molina Healthcare (MI)
- …Description** **Job Summary** The Director , Clinical Data Acquisition for Risk Adjustment , is responsible for the implementation, monitoring, and oversight ... of all chart collection for Risk Adjustment , RADV, or ...audit projects and deliverables related to accurate billing and coding . This role also works with the Health Plan… 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
- ChenMed (Miami, FL)
- …processes + Comprehensive knowledge of Medicare program including but not limited to Risk Adjustment processes and Fee For Service. + Knowledge of applicable ... need great people to join our team. The Associate Director , Revenue Cycle Management (RCM) Optimization manages and organizes...incumbent also serves as a subject matter expert on risk - adjustment and medical economics to aid in… more
- Bristol Myers Squibb (Princeton, NJ)
- …resilience from a Business Continuity Management (BCM), Crisis Response, and proactive risk identification and mitigation perspective. This role will support the BCM ... and tools, including those that drive our BCM planning and proactive risk management capabilities. **Roles and Responsibilities:** + Drive partnership with business… 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
- 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
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