- Somatus (Mclean, VA)
- …physical and mental well-being + Community engagement opportunities + And more! The Sr. Director , Medicare Risk Adjustment (MRA) will lead the execution ... experience required. + Proven experience with commercial and/ or Medicare Advantage risk adjustment functions. + Proven track record of working collaboratively… more
- Travelers Insurance Company (Washington, DC)
- …strategies for addressing and resolving various types of debt, including Medicare , to deliver positive financial outcomes. This role requires leveraging economic ... Support: + Partners with the Field, Claim Resources and Senior Leadership to identify and improve Claim processes and...a financial management and control strategy to limit financial risk associated with claim costs. + Serves as a… more
- CenterWell (Washington, DC)
- …under the PCO's Chief Medical Officer. This role reports to the National Director , High Risk Patient Management. Responsibilities will include: + Lead ... to a Conviva/CenterWell market location(s) + Experience working in a value-based care, senior care, and/or Medicare managed care **Workstyle** This is a remote… more
- Humana (Washington, DC)
- …a part of our caring community and help us put health first** Director of Enterprise Information Protection (EIP) Cybersecurity Engineering focused on building a ... and strategic thinking skills, with the ability to influence senior leaders across EIP. * Proven track record of...Have a bias towards action and delivery while balancing risk management. + Ability to implement best practices for… more
- Guidehouse (Mclean, VA)
- …client relationships, and delivering impactful project results within the Centers for Medicare & Medicaid Services (CMS). You will own the delivery of projects ... role involves leadership of multi-year task orders and regular interaction with senior , executive-level clients to ensure the success of innovative new programs. The… more
- Point32Health (Washington, DC)
- …health care claims data, coding schemes (ICD-9/ICD-10, CPT/HCPCS, DRGs), and health status risk adjustment. + Knowledge of Medicare and Medicaid reimbursement is ... Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** Working with the Director , Network & Provider Analytics and other members of the Network… more
- University of Virginia (Manassas, VA)
- …complete and accurate. + Collaborates with appropriate Clinic Triad team (Medical Director , Access and Clinic Managers) to review requested schedule changes to ... and Check-out: + Completes all registration elements, including the Medicare Secondary Payor Questionnaire (MSPQ), scanning of long-term signatures...are due at the time of service, explain the risk of 'going out of network' for services. Support… more