- CenterWell (Tallahassee, FL)
- …and help us put health first** The Associate Director , Risk Adjustment oversees quality assurance audits of medical records, ICD-10-CM, CPT, & HCPCS ... and over government agencies. In addition, the Associate Director , Risk Adjustment oversees all medical coding education activities. The Associate … more
- Carle (Urbana, IL)
- …with Coding Analysts, Coding Supervisor, Manager, Director , and Medical Director to strategically plan and execute Risk Adjustment coding efforts ... Risk Adjustment Education Specialist - HYBRID...(targeting, key messaging, publications, website updates, provider reports, electronic medical record prompts, etc.). + Serve as a subject… more
- 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 ... 50 miles of a PulsePoint location. The **Business Change Director for Risk Adjustment Data...bonus programs (unless covered by a collective bargaining agreement), medical , dental, vision, short and long term disability benefits,… 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 ... version of themselves, including: + Subsidized, personal healthcare coverage ( medical , dental vision) + Flexible Paid Time Off (PTO)...strategy and implementation of the organization's Risk Adjustment Programs to optimize the programs'… more
- Health First (Rockledge, FL)
- …Government Program Director to develop a comprehensive, long-term Medicare risk adjustment strategy. *Stewardship: * * Responsible for coordinating efforts ... Financial Stewardship by: providing outstanding service by effectively managing and directing the Risk Adjustment department to meet the needs of its internal… more
- Centene Corporation (Tallahassee, FL)
- … record audits, analysis of practice coding patterns, education and training regarding risk adjustment to ensure accurate CMS payment and improve quality of ... and market level. + Subject matter experts for proper risk adjustment coding and CMS data validation...to include Provider Relations, Quality as well as the Medical Director for the state assigned to… 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
- 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
- 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 ... other provider engagement teams within Molina. + Possesses a strong knowledge in risk adjustment programs and processes, data acquisition processes, HEDIS and… more
- Mount Sinai Health System (New York, NY)
- …(2) close partnership with the CDQI Director to drive accurate risk adjustment throughout the system. This Medical Director must be effective at ... improve the status quo **Role Summary:** MSHP seeks a Medical Director (MD), Physician Engagement and CDQI,...population health goals including access, quality, utilization and accurate risk adjustment with a group of practices… 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
- Bristol Myers Squibb (Princeton, NJ)
- …monitoring execution of high- risk activities. Responsibilities Include : + Conduct risk assessments specific to medical affairs and clinical trial /research ... In this role, you will combine your knowledge about risk mitigation strategies , such as education and monitoring,...their decisions. + Under the direction of the Senior Director , US and Above Market Medical and… more
- Bristol Myers Squibb (Princeton, NJ)
- …Read more: careers.bms.com/working-with-us . **Position Summary** We are seeking a WWMO Medical Communications Director with a deep understanding of the relevant ... Affairs and Clinical Development. Position reports to the Executive Director of Medical WWMO Medical ...ability to achieve set objectives; ability to take educated risk , rise above technical expertise; demonstrating judgement, wisdom and… more
- Bristol Myers Squibb (Princeton, NJ)
- …more: careers.bms.com/working-with-us . **Position Summary** We are seeking a Cell Therapy Medical Communications Director with a deep understanding of the ... within Medical Affairs and Clinical Development. Position reports to the Executive Director of Medical Cell Therapy Medical Communications within Global … more
- Molina Healthcare (Phoenix, AZ)
- …regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare,… more
- Bristol Myers Squibb (Princeton, NJ)
- …Ethics Organization, this role partners with senior leaders across Legal, Commercial, Medical , R&D, Global Drug Development, Regulatory, IT, Audit, Finance and HR to ... and integrate one global compliance program into the US Medical O rganization . In this role, you will...In this role, you will combine your knowledge about risk mitigation strategies , such as education and monitoring,… 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 ... with applicable work experience and a complete benefits package which includes: medical , dental, vision, life insurance programs, a 401K plan, and an incentive… more
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