- UCLA Health (Los Angeles, CA)
- Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment , you will be an expert in risk adjustment ... more
- UCLA Health (Los Angeles, CA)
- Description As the Medicare Advantage Risk Adjustment Performance Improvement Consultant, you will be responsible for: + Serving as a Subject Matter ... more
- Elevance Health (Richmond, VA)
- …and performs very complex actuarial studies. **How you will make an impact:** + Insources Medicare Advantage Risk Adjustment Analytics from vendors. + ... more
- Independent Health (Buffalo, NY)
- …implementation of successful activities that improve the accuracy of the CMS risk adjustment scores of the Medicare Advantage membership. This role will ... more
- VNS Health (Manhattan, NY)
- …medical records, including ICD 10 CM or current coding system and medical record systems for Medicare Advantage Risk Adjustment required + 2 years of ... more
- Humana (Columbus, OH)
- …other applied statistical methods + Strong communication/presentation skills **Preferred Qualifications** - Medicare Advantage risk adjustment experience ... more
- CenterWell (Columbus, OH)
- …outcomes + Ability to travel up to 20% **Preferred Qualifications** + Proven experience with Medicare Advantage risk adjustment functions. + Proven track ... more
- CareOregon (Portland, OR)
- … risk adjustment coding and provider education programs for the Medicare Advantage and Medicaid product lines. This function is highly visible, matrixed ... more
- AdventHealth (Maitland, FL)
- …on all contracts and business lines, including Direct-To-Employer, Commercial, ACA Exchange, Medicare , Medicare Advantage , Bundles, and other Network ... more
- Robert Half Office Team (St. Louis, MO)
- … Billing, Medicare Claim, Medicare Risk Adjustment , Medicare Supplements, and Medicare Advantage . * Carrying out audits in the healthcare ... more
- Amazon (San Francisco, CA)
- …will responsible primarily for several critical workstreams which include analysis of Medicare Advantage and Accountable Care Organization data, design and ... more
- Highmark Health (Columbus, OH)
- …and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills including but ... more
- WelbeHealth (Los Angeles, CA)
- …Excel, and financial modeling tools + Deep understanding of CMS risk adjustment , Medicaid rate-setting, and Medicare Advantage /Part D payment models + ... more
- Martin's Point Health Care (Portland, ME)
- …projects involving utilization management, Care Management, Medical Expense, Provider Engagement and Risk Adjustment have a robust plan and meets set deadlines ... more
- New York State Civil Service (NY)
- …Crisis Team. The incumbent will serve as a regional forensic liaison, providing risk assessments, evaluations for transition planning, and serve in a monitoring role ... more
- Novant Health (NC)
- …Quality, Total Cost of Care, Network Integrity, Social Determinants of Health, Risk Adjustment , and Attribution. + Build compelling visualizations, innovative ... more
- Bloom Healthcare (Lakewood, CO)
- …needs and document these findings to support BI-centric solutions, particularly with Medicare Advantage , ACO, and claims data. + Build compelling visualizations, ... more
- Deloitte (Charlotte, NC)
- …+ Experience with Medicaid waivers (ie, 1115, 1915 b/c, 1332) + Experience with risk adjustment mechanisms + Experience with health care reform and working ... more
- Atlantic Health System (Morristown, NJ)
- …filings + Responsibility for supplemental submission of Medicare Risk Adjustment Files associated with Medicare Advantage plans. + Coordination and ... more
- New York State Civil Service (Thiells, NY)
- …education.PRIMARY DUTIES AND RESPONSIBILITIES:* Monitor the need of high nutritional risk individuals in their assigned area (ie, tube feeding, pre-tube feedings, ... more