- The Cigna Group (Houston, TX)
- …(CCS-P) + Registered Health Information Management Technician (RHIT) + 5+ years of risk adjustment coding experience, 3+ national Medicare Advantage health ... along the engagement continuum within an assigned market. Lead Analyst will be primary contact for provider groups on...matrix partners of Cigna Medicare's programs specific to CMS Risk Adjustment and HCC Coding … more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and integrity of key risk ... milestones and key deliverables. Develop tracking and monitoring mechanisms for all Risk Adjustment and Coding programs. Support management in ensuring that… more
- Martin's Point Health Care (Portland, ME)
- …Position Summary **NEW REMOTE POSITION** **Health Plan Operations** **APPLY TODAY!** The Senior Risk Adjustment Analyst analyzes data, reviews findings, and ... used in complex conceptual analyses for all departments within Risk Adjustment Operations + Develops systematic reporting...of third-party analytical tools and reporting platforms related to risk profile analysis and HCC coding +… more
- Providence (Beaverton, OR)
- …an Associate Coding Analyst who will:** + Be responsible for detailed diagnostic coding associated with Risk Adjustment and HCC Coding + Impact ... role in development of Health Plan Payment Rules to risk adjustment **Providence Health Plan welcomes 100%...This posting is for multiple openings for an Associate Coding Analyst + This position is affiliated… more
- UPMC (Pittsburgh, PA)
- …+ Experience with DRG Assignment and clinical validation of diagnoses. + Experience with HCC/ Risk Adjustment coding preferred. + Proficiency using Epic, One ... UPMC Health Plan is looking for an Intermediate Clinical Auditor/ Analyst to join the Quality Assurance team! This role will work standard daylight hours, Monday -… more
- The Cigna Group (Sunrise, FL)
- …on topics including, but not limited to: preventative and quality outcome metrics, risk adjustment , medical cost management, etc. + Schedules, prepares for and ... **Role Summary** The Provider Performance Enablement Lead Analyst is a key member of the market...to Health Services, Medical Economics, Sales, and Sales & Risk Adjustment in order to develop solutions… more
- CVS Health (Hartford, CT)
- …Analyst within the Revenue Integrity COE organization, you will be supporting Risk Adjustment technical activities, not limited to electronic medical record ... + Experience in system design. **Preferred Qualifications** + Experience with CMS Risk Adjustment programs + Ability to influence others by turning… more
- AdventHealth (Maitland, FL)
- …in understanding professional and facility claims and managed care concepts such as risk adjustment , capitation, FFS, DRG, APG, APCs and other payment mechanisms ... (Altamonte Springs,FL)** **The role you'll contribute:** A Senior Medical Economics analyst is responsible for analyzing and evaluating financial and economic data… more
- Intermountain Health (Salt Lake City, UT)
- …of federal and state laws and regulations related to health care billing, coding , reimbursement, contracting, and risk adjustment , such as Medicare, ... **Job Description:** The Compliance & Ethics Analyst - Senior acts as a consultant, investigator,...and Intermountain companies. Areas of responsibility may include privacy risk assessment, privacy contracting (BAAs and DUAs), privacy policies,… more
- Evolent Health (Columbus, OH)
- …knowledge of Medicare claims, episode and condition groupers, case/episode and risk adjustment , patient attribution methodologies, and network analysis and ... the culture. **What You'll Be Doing:** **Job Posting: Senior Analyst , Performance Analytics** **Location: Remote** Evolent is seeking a...+ 1+ years performing analyses in one or more coding language (SAS, R, Python) + 1+ years performing… more
- Point32Health (Canton, MA)
- …claims data, coding schemes (ICD-9/ICD-10, CPT/HCPCS, DRGs), and health status risk adjustment . In-depth health care reimbursement and managed care business ... direction of the Director or Senior Manager, the Senior Analyst will be part of a team responsible for...ad hoc requests. The Senior Network & Provider Analytics Analyst may also serve as a project manager and/or… more
- Molina Healthcare (MI)
- …of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), ... **JOB DESCRIPTION** **Job Summary** The Senior Analyst , Medical Economics provides support and consultation to the Health Plan and Finance team through analyzing key… more
- reveleer (Los Angeles, CA)
- …plans across all business lines greater control over their Quality Improvement, Risk Adjustment , and Member Management programs. With one transformative ... every aspect of enrollment, provider outreach and data retrieval, coding , abstraction, reporting, and submissions. Leveraging proprietary technology, robust data… more
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