- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Risk Adjustment QA Consultant Location: Hybrid | Eagan, Minnesota Career ... to make a difference, join us. The Impact You Will Have As a Risk Adjustment Quality Assurance (QA) Consultant at BCBSMN, you'll play a critical role in ensuring… more
- Ankura (New York, NY)
- …investigations, and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment . The Senior Director will also support practice ... of activities: + Help clients manage proactive and reactive Medicare and Commercial Risk Adjustment compliance, audit, and investigation projects for clients. +… more
- Point32Health (Canton, MA)
- …Point32Health (https://www.point32health.org/) . **Job Summary** This position will lead the Risk Adjustment Operations & Provider Consulting team responsible ... engagement and consultation activities supporting the complete and accurate capture of risk adjustment data. To be successful, the Manager will need to rely on… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior ACA Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and integrity of ... key risk adjustment performance metrics through coordination of analytical processes, investigation and interpretation of HHS risk score methodology, risk… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Risk Adjustment Business Operations Analyst assumes a pro-active approach in ensuring the accuracy and ... integrity of key risk adjustment performance metrics through coordination of analytical processes, investigation and interpretation of regulated markets risk … more
- Elevance Health (West Des Moines, IA)
- ** Risk Adjustment Actuarial Analyst II - Advanced Analytics** **On-Site Requirement:** **Hybrid 1;** **This role requires associates to be in-office 1 - 2 days ... unless an accommodation is granted as required by law._ The ** Risk Adjustment Actuarial Analyst II - Advanced Analytics** is responsible for completing… more
- Centene Corporation (Jefferson City, MO)
- …the Continental United States. **Position Purpose:** Executes Line 2 oversight of Risk Adjustment activities, including monitoring, auditing, and supports Line 1 ... and complete diagnosis coding in alignment with HCCs and other risk adjustment models. Identifies and evaluates clinical documentation gaps, assesses risk… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Operations Supervisor supports the execution of the corporate coding strategy across Medicare ... risk conditions from the accurate collection, submission, and validation of risk adjustment data. Ensuring compliance with regulatory standards that ensure… more
- Molina Healthcare (Mesa, AZ)
- …DESCRIPTION** **Job Summary** Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintain risk ... identify risks. Additional leadership opportunities are available to lead national risk adjustment studies. Prior experience in Medicaid risk adjustment… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Specialist supports the retrospective risk adjustment supplemental filing, Risk ... and documentation guidelines. The development and ongoing maintenance of the Risk Adjustment Coding guidelines, as well as, guiding junior coding specialists are… more
- Avera (Sioux Falls, SD)
- …where you matter.** **A Brief Overview** Responsible for activities focused around Risk Adjustment (RA) initiatives 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… more
- MVP Health Care (Rochester, NY)
- …innovative thinking and continuous improvement. To achieve this, we're looking for a ** Risk Adjustment Analyst** to join #TeamMVP. This is the opportunity for ... prospective and retrospective objectives in population health management including focus on Risk Adjustment efforts. + Design targeting based upon disparate data… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- The ** Risk Adjustment & Quality Division at BCBST** is seeking a skilled ** Risk Adjustment Medical Record Coder** to support our mission of delivering ... per week in accordance with BCBST policy\. **Preferred Qualifications:** + CRC \(Certified Risk Adjustment Coder\) certification is a plus\. If not currently… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- …experienced leader with a strong background in medical records coding and quality assurance? Risk Adjustment is looking for a **Supervisor** to lead a dynamic ... team dedicated to accuracy and compliance in risk adjustment coding\. **About the Team:** This team plays a critical role in reviewing medical records, capturing… more
- Wolters Kluwer (Austin, TX)
- …| Wolters Kluwer (https://www.wolterskluwer.com/en/solutions/health-language)** **Coder Workbench Solution:** ** Risk Adjustment Software | Health Language ... the Eastern or Central time zone, have a solid understanding of risk adjustment in the Healthcare Technology space, experience with Payer, Provider, and Vendor,… more
- Trinity Health (Livonia, MI)
- **Employment Type:** Full time **Shift:** **Description:** **CERTIFIED RISK ADJUSTMENT CODING SPECIALIST** **Location:** Trinity Health PACE Corp Michigan ... thru AHIMA** + **Must be certified or obtaining certification for Certified Risk Adjustment Coder thru AAPC. If not obtaining, must obtain within one year… more
- Corewell Health (Grand Rapids, MI)
- About the Position The Population Health RN - Risk Adjustment Specialist will play a critical role in improving clinical documentation for Hierarchical Condition ... clinical expertise with health technology to ensure documentation supports accurate risk adjustment , quality reporting, and optimal patient care outcomes.… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Quality & Risk Adjustment Provider Consultant Location: Hybrid | Eagan, Minnesota Career ... experience * Knowledge of Health Care Quality measures * Certified Risk Adjustment Coder (CRC via AAPC) or Certified Professional Coder (CPC via… more
- Ascension Health (Elk Grove Village, IL)
- …Candidates must have the following certification thru AAPC (credentialing board): **Certified Risk Adjustment Coder (CRC) - STRONGLY PREFERRED** + **Hybrid ... + **Current Students in the CRC program please apply!** + 1 year ** RISK CODING** experience, preferred (NEW GRADUATES WELCOME) + Experience in HCC or chronic… more
- Datavant (Atlanta, GA)
- …Coding Supervisor serves as a working supervisor with oversight and management of Risk Adjustment team members. This includes monitoring production and quality ... of employees' work, process improvements and clear communication of expectations. This position supports and coaches front line talent to ensure the highest level of service to clients and ultimately the patient lives we impact. **You will:** + Supervise… more
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