• Risk Adjustment Compliance…

    Humana (Des Moines, IA)
    …understanding of how organization capabilities interrelate across the function or segment. The Risk Adjustment Director of Compliance ensures compliance with ... understanding of how organizational capabilities interrelate across the function or segment. The Risk Adjustment Director of Compliance will be a key… more
    Humana (03/11/25)
    - Save Job - Related Jobs - Block Source
  • IPA Coding Associate Director

    CenterWell (Des Moines, IA)
    …+ Ability to travel up to 20% **Preferred Qualifications** + Proven experience with Medicare Advantage risk adjustment functions. + Proven track record of ... entities within the Primary Care Organization. **Strategy:** + In partnership with AVP, Risk Adjustment and AVP, MRA Strategy, responsible for driving ongoing… more
    CenterWell (03/06/25)
    - Save Job - Related Jobs - Block Source
  • Medical Director (Marketplace)

    Molina Healthcare (Des Moines, IA)
    …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 (02/06/25)
    - Save Job - Related Jobs - Block Source
  • Population Health Director , Field

    CVS Health (Des Moines, IA)
    …to, transitions-in-care, pharmacy and medication adherence, HEDIS / Stars, accurate risk adjustment , preferred partner relationships, and patient engagement ... heart, each and every day. **Company:** Oak Street Health **Title:** Population Health Director , Field **Company Description** The mission of Oak Street Health is to… more
    CVS Health (03/18/25)
    - Save Job - Related Jobs - Block Source
  • Reg Mgr, Value-Based Prgms

    Molina Healthcare (Des Moines, IA)
    …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
    Molina Healthcare (03/13/25)
    - Save Job - Related Jobs - Block Source
  • Case Manager RN

    Trinity Health (Des Moines, IA)
    …patient and family. + Has a working knowledge of financial and reimbursement processes Medicare DRG payment, Case Rates, Managed Care Risk Contracting, etc. + ... condition, support systems and resources, client/family knowledge, perception and adjustment towards disease process, and community resources. + Screens… more
    Trinity Health (02/21/25)
    - Save Job - Related Jobs - Block Source