- Molina Healthcare (St. Petersburg, FL)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare ,… more
- Molina Healthcare (St. Petersburg, FL)
- …quality and risk adjustment VPs, Regional Directors of Quality/ Risk , Director of Value Based Programs, medical economics/actuaries and local health ... revenue management, strategy, and compliance + Knowledge of value based programs, risk adjustment models, quality metrics such as HEDIS and STARS, knowledge… more
- AdventHealth (Tampa, FL)
- …Guidelines and approved coding policies and procedures. . Participates in the mortality/ risk adjustment reviews when assigned. . Assists with post-payment DRG ... coding accuracy retrospectively and concurrently as assigned by manager and/or Director . . Reviews and addresses all third party/Regulatory Agencies requests for… more