- HCA Healthcare (Campbell, CA)
- …We care like family! Jump-start your career as a(an) Manager of Quality - Risk Adjustment Programs today with HCA Healthcare. **Benefits** HCA Healthcare, ... join our team as a(an) Manager of Quality - Risk Adjustment Programs . We care...develop and implement a high-performing and compliant quality and risk adjustment program . The Manager's… more
- Independent Health (Buffalo, NY)
- …and a culture that fosters growth, innovation and collaboration. **Overview** The Medicare Risk Adjustment Program Manager will be accountable for the ... program deliverables are achieved on time. The Medicare Risk Adjustment Program Manager will...end-to-end management, delivery and support to new and existing Risk Adjustment programs through development,… more
- Centene Corporation (Springfield, IL)
- …the future. Evaluate and oversee the development and implementation of CMS and HHS risk adjustment program changes. Incorporate changes and requirements into ... and oversee an effective and optimal Risk Adjustment submission process and Quality Assurance Program ....and implement employee training and provider outreach programs , as needed, to improve Risk … more
- MedKoder (Mandeville, LA)
- …a flexible schedule. Description: MedKoder, LLC is seeking a remote Professional HCC Risk Adjustment Coder who will apply both technical and specialized ... expertise to help healthcare programs remain compliant with government regulations while identifying opportunities...while identifying opportunities for increased financial success. The HCC Risk Adjustment Coder provides coding services to… more
- Molina Healthcare (Rochester, NY)
- …Health Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities. ... Provider Engagement plan to meet annual quality & risk adjustment performance goals. May engage Tier...quality efforts (eg Supplemental data, EMR connection, Clinical Profiles programs ) and use of the Molina Provider … more
- Point32Health (Canton, MA)
- …up and manage secure file transfer sites for vendors that support our risk adjustment programs . **Collaboration with Internal/External Stakeholders** + ... specific to risk score trends, truncation report, data/claims submissions and program performance to support risk adjustment analytics; deliver timely… more
- UCLA Health (Los Angeles, CA)
- Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment , you will be an expert in risk adjustment coding and ... documentation, working closely with physicians, IPA coders, and risk adjustment teams associated with the health plan. You will: + Conduct medical record audits… more
- Elevance Health (Louisville, KY)
- …as it pertains to CMS guidelines. **How you will make an impact:** + Leads Risk Adjustment operations including provider education, data analysis, audits and ... 2 years' experience in healthcare industry and expertise in Risk Adjustment ; or any combination of education...or any combination of education and experience, which would provide an equivalent background. + AAPC (American Academy of… more
- Ascension Health (Des Plaines, IL)
- …Candidates must have the following certification thru AAPC (credentialing board): **Certified Risk Adjustment Coder (CRC) - STRONGLY PREFERRED** + **Hybrid ... Years of Experience:** + **Current Students in the CRC program please apply!** + 1 year ** RISK ...identify inaccurate or unclear documentation and coding relating to risk adjustment and version 28 HCC ICD-10… more
- Elevance Health (Grand Prairie, TX)
- ** Risk Adjustment Encounters Analyst - Medicare / Medicaid** **Location:** This position will work a hybrid model (remote and office). The Ideal candidate will ... of one of our Elevance Health PulsePoint locations. The ** Risk Adjustment Encounters Analyst - Medicare /...and analyzes business performance reports (eg for claims data, provider data, utilization data) and provides notations of performance… more
- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- The Risk Adjustment Medical Record Retrieval team...In this role, you will be traveling to local provider offices in the **Memphis TN** area to acquire ... willing to travel locally on a regular basis to provider offices, with overnight stays on occasion\. While this...will be automatically enrolled into the BCBST Driver Safety Program \. The employee will also be required to adhere… more
- Molina Healthcare (Dayton, OH)
- …& ABILITIES:** * 4+ years of program and/or project management experience in risk adjustment and/or quality * 4+ years of experience supporting HEDIS engine ... limited to: Risk /Quality rate trending and forecasting; provider Risk /Quality measure performance, CAHPS and survey...activity, risk adjustment targeting and reporting systems *… more
- VNS Health (Manhattan, NY)
- …the Risk Adjustment and Quality teams, you'll help shape educational programs that elevate provider knowledge and drive success across the board. If you ... programs . + Designs and develops teaching plans and program content for provider education and ensure...Certifications: + Certified Professional Coder (CPC) or (CRC) Certified Risk Adjustment Coder or Certified Coding Specialist… more
- Molina Healthcare (Dayton, OH)
- …& ABILITIES:** * 2+ years of program and/or project management experience in risk adjustment and/or quality * 2+ years of experience supporting HEDIS engine ... limited to: Risk /Quality rate trending and forecasting; provider Risk /Quality measure performance, CAHPS and survey...activity, risk adjustment targeting and reporting systems *… more
- Banner Health (AZ)
- …efforts in support of achieving organizational strategic initiatives related to the organization's Risk Adjustment program goals. This position is also ... 's financial benefit to Banner Health. 4. Partners with Risk Adjustment resources to provide ...partnership. 7. Participates in or leads Risk Adjustment projects designed to improve program offerings… more
- Fairview Health Services (St. Paul, MN)
- …documentation for clinical conditions and procedures to reflect severity of illness, risk adjustment , accurate coding, accuracy of patient outcomes, and ... informally, regarding the impact of documentation on patient care, quality metrics, risk adjustment , and correct reimbursement. Adheres to departmental and… more
- Fallon Health (Worcester, MA)
- …strive to be the leading provider of government-sponsored health insurance programs -including Medicare, Medicaid, and PACE ( Program of All-Inclusive Care for ... coded * Assist in the collection and analysis of risk adjustment data in-order to identify documentation,...records to increase the accuracy, clarity and specificity of provider documentation. * Provide feedback to providers… more
- Medical Mutual of Ohio (Toledo, OH)
- **Job Summary:** Optimizes/reviews documentation for the application of risk adjustment coding for ACA (Affordable Care Act) and MA (Medicare Advantage) with ... precise medical codes. Audits vendors for quality assurance of risk adjustment coding for ACA and MA....specifications + Basic knowledge and understanding of hospital and provider operations as it applies to medical coding and… more
- HSBC (New York, NY)
- …all relevant risk areas eg credit risk , counterparty credit risk , securitization, and Credit Valuation Adjustment ('CVA'). GRPA currently maintains a ... the establishment of interpretations and governance processes to mitigate regulatory risk . GRPA also monitors new rule developments and other ongoing changes… more
- AdventHealth (Maitland, FL)
- …Accountable for improvement in clinical documentation accuracy through oversite of the risk adjustment team, including accountability for: o Ensuring clinical ... programs with over 13,500 episodes and $395M in program size. The Chief Finance Officer is responsible for...in place for the accurate and complete reporting of Risk Adjustment Factor (RAF) scores. o Driving… more