- Henry Ford Health System (Troy, MI)
- …Risk Coding and Education Specialist - Level II, specific to the Risk Adjustment Coding and Clinical Education team will perform retrospective, ... prospective chart reviews and audits under direction of the Manager /Lead. Identifies trends and educational opportunities for both administrative...and coding of CMS Medicare Advantage (MA) Risk Adjustment Data Validation (RADV) and vendor… more
- ChenMed (Miami, FL)
- …We're rapidly expanding and we need great people to join our team. The Risk Adjustment Auditor works in a collaborative effort directly with physicians, their ... ensure that medical documentation and supportive evidence complies with risk adjustment initiatives, improving revenue cycle and...Coder) is required, or additional 3 years' experience in risk adjusting coding in lieu of certification… more
- UCLA Health (Los Angeles, CA)
- …officer and the manager of coding and education. The Assistant Director of Risk Adjustment will oversee the manager of the coding team and ... do all this and more at UCLA Health. As member of the Medicare Advantage Risk Adjustment leadership team, the Assistant Director of Risk Adjustment is… more
- Medical Mutual of Ohio (OH)
- …Medicare Supplement, and individual plans. _Collaborates with internal departments on risk adjustment coding strategies, HEDIS performance, provider ... delivery approach and assist in the review of provider agreements.** + **Acts as project manager over large internal risk adjustment projects (eg, Optum In… more
- Henry Ford Health System (Troy, MI)
- …that assure HAP's provider community improve with accurate submission of clinical documentation and coding of risk adjustment data through a combination of ... documentation. Serve as a subject matter expert to internal/external customers regarding MA/QHP risk adjustment and medical record coding . + Participates in… more
- R1 RCM (Chicago, IL)
- …team to ensure accurate and efficient coding of patient diagnoses for risk adjustment purposes. This role involves managing coding operations ensuring ... operating costs and enhancing the patient experience. As our Manager of HCC Coding and Audit, you...coding processes. You will perform compliance audits, including risk -based audits and quality review (QR) monitoring, as needed.… more
- Trinity Health (Livonia, MI)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Certified Medical Coding Manager - Remote** **Location:** Trinity Health PACE Corp ... to 330 pm Eastern **Position Purpose:** The Certified Medical Coding Manager oversees the Coding ...Clinical Documentation & HIM to analyze the quarterly Semi-Annual Risk Adjustment Reporting Suite and develop strategies… more
- Catholic Health Initiatives (Chattanooga, TN)
- …and committees as appropriate. + Reports areas of risk directly to the Coding Integrity Manager /Supervisor. + Maintains a high level of competency related to ... team to support the needs of the organization. The position will support risk adjustment improvement efforts across the medical group. The Hierarchical Condition… more
- Elevance Health (Nashville, TN)
- …medical terminology and anatomy strongly preferred. + Experience with the most current CMS Risk Adjustment Model strongly preferred. + AAPC Certified Risk ... 50 miles of any Elevance Health PulsePoint office The ** Coding Analyst Senior** is responsible for reviewing, auditing, and...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Hartford HealthCare (Farmington, CT)
- …specialist will support documentation practices that comply with CMS risk adjustment program requirements and ICD 10 coding guidelines. Reporting to ... *This Job Reports To (Job Title):*Audit and Education Specialist Manager *Education* . Minimum: o Medical Coding ...Hartford Healthcare o Experience with the nuances of diagnosis coding and risk adjustment programs… more
- CVS Health (Columbus, OH)
- …Certified Professional Medical Auditor (CPMA), Certified Outpatient Coder (COC), Certified Risk Adjustment Coder (CRC) Licensed Clinical Social Worker (LCSW) ... a Manager to lead our team of Certified Professional Coders (CPC). The Manager is responsible for overseeing and managing coding reviews for fraud detection,… more
- CenterLight Health System (Stilwell, OK)
- …Coder (CPC) + Certified Professional Medical Auditor (CPMA) + Certified Professional Practice Manager (CPPM) + Certified Risk Adjustment Coder (CRC) ... JOB PURPOSE: Responsible for supervising, evaluating and consistently improving the Coding & Medical Practice operations. In conjunction with each DTC Physician,… more
- Geisinger (Danville, PA)
- … certification is required:CPC - Certified Professional Coder CRC - Certified Risk Adjustment Coder RHIT - Registered Health Information Technician Education ... complete and accurate coding . + Communicates to Coding Quality and Professional Manager any new...of 5 years-Relevant experience* (Required) Certification(s) and License(s) Certified Risk Adjustment Coder - American Academy of… more
- Penn State Health (Hershey, PA)
- …and coordination with contracted payors, tracking and trending of KPIs, and ensuring accurate risk adjustment . The Program Manager will need to provide ... Based Care - Operations. We are seeking an experienced and detail-oriented Program Manager for Disease Burden Capture. The Program Manager will lead initiatives… more
- Amazon (Jersey City, NJ)
- Description FinTech Lyra is seeking a passionate Software Development Manager to lead our team in developing and maintaining cutting-edge technology solutions for ... ensuring compliance and controllership. In this role, you will drive operational risk management initiatives and collaborate with partner teams to deliver solutions… more
- Marshfield Clinic (Marshfield, WI)
- …external stakeholders as it relates to Medicare Advantage, ACA/Exchange and Medicaid risk adjustment reimbursement methodologies and policies to ensure the ... educational and training resource materials to assist providers in coding accuracy. The Educator develops and implements strategic action,...accuracy and integrity of risk adjustment data submitted to the Centers… more
- BronxCare Health System (Bronx, NY)
- Overview The Nurse Manager is responsible on the night shift (4 ten hour shifts), for quality and safety of outcomes consistent with the philosophy and goals of the ... insttitution. The Nurse Manager facilitates employee and patient satisfaction through professional oversight. Responsibilities 1. CUSTOMER PATIENT FOCUS * Establish… more
- reveleer (CA)
- …plans across all business lines greater control over their Quality Improvement, Risk Adjustment , and Member Management programs. With one transformative ... Product Manager , Analytics (Healthcare) Remote Opportunity Reveleer is a...every aspect of enrollment, provider outreach and data retrieval, coding , abstraction, reporting, and submissions. Leveraging proprietary technology, robust… 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 ... Finance Manager Onsite - Glendale, CA Reveleer is a...every aspect of enrollment, provider outreach and data retrieval, coding , abstraction, reporting, and submissions. Leveraging proprietary technology, robust… more
- Amazon (New York, NY)
- …a mentor that works best for you based on location, job family, job level etc. Your manager can also help you find a mentor or two, because two is better than one. ... Web Services is seeking an unconventional, visionary, and driven Senior Technical Product Manager for AWS Commerce Platform. Our fast-growing team builds AI / ML… more
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