• Validation Specialist , Quality Assurance

    Astellas Pharma (Westborough, MA)
    **Validation Specialist , Quality Assurance** Do you want to be part of an inclusive team that works to develop innovative therapies for patients? Every day, we are ... range of disease indications, ranging from macular degeneration (currently in clinical trials) and other ocular indications to vascular and autoimmune disease.… more
    Astellas Pharma (01/16/25)
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  • Hierarchical Condition Category (HCC) Coding…

    Highmark Health (Providence, RI)
    …categories. Supports other key objectives to drive capture of correct Risk Adjustment coding including documentation improvement, provider education, analyzing ... **Required** (any of the following) + Certified Professional Coder (CPC) + Certified Risk Coder (CRC) + Certified Coding Specialist (CCS) + Registered Health… more
    Highmark Health (03/04/25)
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  • Recovery Specialist Supervisor (Women's…

    Veterans Inc. (Worcester, MA)
    …Substance Abuse Treatment program, which is open to veterans. The Recovery Specialist Supervisor is responsible for the day-to-day oversight and supervision of the ... supervision and capacity building, and ensures supervision during the times that the Clinical and Program Managers are not on-site. The qualified candidate must have… more
    Veterans Inc. (03/10/25)
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  • Referral & Resource Specialist

    Elevance Health (Smithfield, RI)
    **Referral & Resource Specialist ** **Location:** This is a **remote** position. Candidates must reside in one of the following states : **MASSACHUSETTS, NEW ... companies, Carelon Behavioral Health, formerly Beacon Health Options, offers superior clinical mental health and substance use disorder management, a comprehensive… more
    Elevance Health (01/10/25)
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  • Risk Adjustment Auditor I

    Baylor Scott & White Health (Providence, RI)
    …**KEY SUCCESS FACTORS** + Knowledge of ICD-10-CM and CPT coding conventions, and clinical documentation + Knowledge of and compliance with standards of ethical ... + Conducts provider audits and creates provider scorecards to offer feedback on Risk Adjustment Methodology + Interprets health record documentation to code and… more
    Baylor Scott & White Health (03/13/25)
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  • Coding Auditor Educator

    Highmark Health (Providence, RI)
    …Reviews medical records to determine data quality and accuracy of coding, billing and documentation related to DRGs, APCs, CPTs and HCPCS Level II code and modifier ... areas. Uses information to generate topics for education, training, process changes, risk reduction, optimization of reimbursement with new and current coders in… more
    Highmark Health (02/07/25)
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  • Investment Performance (PMA) Business Analyst

    Eliassen Group (Smithfield, RI)
    …of companies reach further and achieve more with their technology solutions, financial, risk & compliance, and advisory solutions, and clinical solutions. With ... to join the Performance Measurement & Analysis (PMA) product area's Performance Specialist Team. This team is dedicated to supporting PMA in delivering new… more
    Eliassen Group (03/08/25)
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