- Humana (Tallahassee, FL)
- …part of our caring community and help us put health first** The Senior Risk Adjustment Administration Professional will work closely with providers to identify ... guidance around operational and clinical best practices in the risk adjustment methodology. This role reports to...health management through Point of Care Alerts and Supplemental Data (ie preferably Epic, Athena and eCW). + Facilitate… more
- MyFlorida (Tallahassee, FL)
- …Estimator Tool (https://compcalculator.myflorida.com/) OPEN COMPETITIVE EMPLOYMENT OPPORTUNITY DIVISION: RISK MANAGEMENT BUREAU: STATE LIABILITY AND PROPERTY ... data ; to make and defend decisions about insurance claims ; to plan, organize & coordinate work activities; to...offers of settlement up to approved authority and denying claims when necessary. Responsible for the adjustment … more
- Centene Corporation (Tallahassee, FL)
- …and NCQA requirements. + Collects, summarizes, trends, and delivers provider quality and risk adjustment performance data to identify and strategize/coach on ... provider facing teams to improve provider performance in areas of Quality, Risk Adjustment and Operations ( claims and encounters). + Identifies specific… more