• Associate Director , Risk

    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
    CenterWell (10/30/24)
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  • Risk Adjustment Education Specialist…

    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
    Carle (09/10/24)
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  • 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 ... 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
    Elevance Health (11/02/24)
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  • 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 ... 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
    Somatus (10/09/24)
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  • 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 ... Financial Stewardship by: providing outstanding service by effectively managing and directing the Risk Adjustment department to meet the needs of its internal… more
    Health First (11/07/24)
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  • Risk Adjustment Auditor Educator

    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
    Centene Corporation (09/25/24)
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  • 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)
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  • 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)
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  • 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)
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  • 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)
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  • 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 ... other provider engagement teams within Molina. + Possesses a strong knowledge in risk adjustment programs and processes, data acquisition processes, HEDIS and… more
    Molina Healthcare (11/07/24)
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  • Medical Director Physician…

    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
    Mount Sinai Health System (09/02/24)
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  • 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)
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  • Associate Director , Compliance and Ethics…

    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 (11/03/24)
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  • Director , Worldwide Medical

    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 (11/07/24)
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  • Director , Cell Therapy Medical

    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
    Bristol Myers Squibb (11/07/24)
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  • Medical Director - Medicare

    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
    Molina Healthcare (11/02/24)
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  • Director , Compliance and Ethics…

    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
    Bristol Myers Squibb (11/03/24)
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  • 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)
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  • 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 ... with applicable work experience and a complete benefits package which includes: medical , dental, vision, life insurance programs, a 401K plan, and an incentive… more
    BP Americas, Inc. (10/31/24)
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