• Risk Adjustment Consultant

    Point32Health (Canton, MA)
    …Work collaboratively with risk adjustment provider educators and the quality assurance team to focus the provider training and education specifically ... individual will support the operations and analysis of all risk adjustment programs and serve as the...ad hoc analyses to improve awareness and understanding of risk scores and the quality , accuracy and… more
    Point32Health (05/31/24)
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  • Medicare Quality Coding Review and Audit…

    The Cigna Group (Houston, TX)
    … Review Audit Manager is responsible for day-to-day oversight of the Risk Adjustment coding quality assurance operations for the Cigna Medicare segment. ... Responsibilities:** + End-to-end management of multiple cross-functional and focused risk adjustment coding initiatives that vary widely...with Quality Review Audit Advisor to ensure Risk Adjustment coding activities performed by their… more
    The Cigna Group (06/11/24)
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  • Risk Adjustment Auditor Educator

    Centene Corporation (Columbia, SC)
    …medical record audits, analysis of practice coding patterns, education and training regarding risk adjustment to ensure accurate CMS payment and improve ... and market level. + Subject matter experts for proper risk adjustment coding and CMS data validation...the RADV Committee as subject matter experts. + Perform quality assurance auditing (ie ensure appropriateness and… more
    Centene Corporation (05/10/24)
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  • Risk Adjustment Auditor Educator

    Centene Corporation (NV)
    …medical record audits, analysis of practice coding patterns, education and training regarding risk adjustment to ensure accurate CMS payment and improve ... and market level. + Subject matter experts for proper risk adjustment coding and CMS data validation...the RADV Committee as subject matter experts. + Perform quality assurance auditing (ie ensure appropriateness and… more
    Centene Corporation (06/15/24)
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  • Risk Adjustment Auditor Educator

    Centene Corporation (Yuma, AZ)
    …medical record audits, analysis of practice coding patterns, education and training regarding risk adjustment to ensure accurate CMS payment and improve ... and market level. + Subject matter experts for proper risk adjustment coding and CMS data validation...the RADV Committee as subject matter experts. + Perform quality assurance auditing (ie ensure appropriateness and… more
    Centene Corporation (06/06/24)
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  • Sr Risk Adjustment Specialist

    Atrius Health (Newton, MA)
    …before missing diagnoses are added. Acts as a mentor and role model to Risk Adjustment Specialist RNs assuring that they are practicing in accordance with ... clinical guidelines for accuracy and documentation. Responsible for the quality assurance process by auditing abstracted chart...electronic medical record. Is an active member of the Risk Adjustment Team, participating in creating and… more
    Atrius Health (05/10/24)
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  • VP, Quality & Controls Assurance

    Commonwealth Care Alliance (Boston, MA)
    …and utilization, among other department activities. + Inform and advise the SVP, Fraud Risk Management & Quality Assurance and the Chief Risk ... claims reviews; call center and digital communications reviews; Medicare Risk Adjustment , HCC, clinical and coding reviews;...years of audit (internal and/or external), quality assurance /review, internal controls and assurance , risk more
    Commonwealth Care Alliance (05/26/24)
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  • Director, Quality & Control…

    Commonwealth Care Alliance (Boston, MA)
    …Experience:** + 8+ years of audit (internal and/or external), quality assurance /review, internal controls and assurance , risk management, corporate ... and ensure accuracy of Quality & Control Assurance policies & procedures, SOPs, risk assessments,...claims reviews; call center and digital communications reviews; Medicare Risk Adjustment , HCC, clinical and coding reviews;… more
    Commonwealth Care Alliance (05/15/24)
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  • Quality Assurance Auditor

    Actalent (Lancaster, SC)
    QA Auditor The Quality Assurance Auditor reports to the Director of Quality . This role is responsible for developing and maintaining a strong Internal ... including the Approved Vendor List. Determine the level of risk of findings identified and follow up on corrective...inspections. Provide support to the South Carolina and Maryland Quality Assurance team. Report audit metrics to… more
    Actalent (06/29/24)
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  • Quality Assurance Auditor

    Actalent (Lancaster, SC)
    The Quality Assurance Auditor reports to the...the Approved Vendor List. + Determine the level of risk of findings identified and follow up on corrective ... prioritizing areas of the business where there is a risk of non-compliance and assist in development and/or execute...+ Provide support to the South Carolina and Maryland Quality Assurance team. + Report audit metrics… more
    Actalent (06/29/24)
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  • Sr. Director, CMC Quality Assurance

    Mitsubishi Chemical Group (Jersey City, NJ)
    …evidence, and creating hope for all facing illness. As a Senior Director of Quality Assurance CMC, you will be responsible for providing operational leadership ... quality reviews. + Lead and or participate in risk assessment and implement appropriate quality and...or related fields" + 15+ years of progressive GMP/CMC Quality Assurance experience with 7+ years in… more
    Mitsubishi Chemical Group (06/15/24)
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  • Analyst- Quality Assurance

    Baptist Memorial (Memphis, TN)
    Summary Quality Assurance Analysts evaluate the adequacy and effectiveness of internal and operational controls designed to ensure that processes and practices ... midstream and downstream revenue cycle activities that impact the adjustment processing of claims. + Conducts risk ...+ Employee referral program Job Summary: Position: 13173 - Analyst- Quality Assurance Facility: BMH - Central Business… more
    Baptist Memorial (06/20/24)
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  • Quality Assurance Manager

    Actalent (Buffalo, NY)
    Quality Assurance . This role drives food safety and quality policies through risk assessment and implementation of requirements, policies, procedures, ... Quality Assurance Manager in Food Science...request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process… more
    Actalent (07/02/24)
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  • Quality Assurance Engineer - MHE

    Actalent (Seattle, WA)
    Job Title: Quality Assurance Engineer Job Description The successful candidate will manage technology or integration projects, delivering solutions to meet ... and distribution center designs. The role also includes supporting Quality Assurance for the team, asset list...to be on-site during HV1 and HV2 testing, generate risk reports weekly, create standard work generation, act as… more
    Actalent (06/29/24)
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  • MHE Quality Assurance Engineer - 50%…

    Actalent (Seattle, WA)
    Job Title: Quality Assurance Engineer Job Description The successful candidate will manage technology or integration projects, delivering solutions to meet ... and distribution center designs. The role also includes supporting Quality Assurance for the team, asset list...to be on-site during HV1 and HV2 testing, generate risk reports weekly, create standard work generation, act as… more
    Actalent (06/22/24)
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  • Sr. Specialist, Quality Assurance

    Bristol Myers Squibb (Summit, NJ)
    …critically review investigations, interpret results and generate technical conclusions consistent with Quality risk management principles. + Must be able to note ... Advanced degree, in a science area. + 5 years Quality Control and/or Quality Assurance ...in their roles. Applicants can request a reasonable workplace accommodation/ adjustment prior to accepting a job offer. If you… more
    Bristol Myers Squibb (06/28/24)
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  • Quality Assurance Specialist

    Actalent (Riverside, CA)
    …generates batch records and COAs and use Excel and Word Skills: gmp, quality assurance , nutraceutical, sop, documentation review, fda, fda compliance, document ... Description: Primarily creation of document, not routine work Do Risk analysis Creating reports: COAs and investigations DCR - document change request - they have a… more
    Actalent (06/25/24)
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  • Quality Assurance Specialist

    Actalent (Riverside, CA)
    …industry** Description: + Primarily creation of document, not routine work + Do Risk analysis + Creating reports: COAs and investigations + DCR - document change ... would like to request a reasonable accommodation, such as the modification or adjustment of the job application process or interviewing process due to a disability,… more
    Actalent (06/25/24)
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  • Senior Auditor, Global Internal Audit…

    Bristol Myers Squibb (Princeton, NJ)
    …careers.bms.com/working-with-us . **Position:** Senior Auditor, Global Internal Audit & Assurance **Location** : Princeton, New Jersey **Position Summary:** The ... in a team environment to plan and execute dynamic risk -based audits and identify value-added recommendations to strengthen Company...to drive assigned sections of the audit with high quality and within deadlines. + Leverage existing data analytics… more
    Bristol Myers Squibb (07/01/24)
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  • Vendor Risk Manager - Data Supplier SME…

    Bloomberg (New York, NY)
    …environment **We'd love to see:** + Experience in the field of Data Management, Risk Assurance , Risk Management, Internal Audit, or other Control functions ... supplier agreements, contractual terms, and service level agreements + Experience in developing risk metrics + Familiarity with Data Quality standards (eg, ISO… more
    Bloomberg (06/25/24)
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