- Elevance Health (Woburn, MA)
- ** Director of Medicare Risk Adjustment Analytics and Reporting** **Location:** Alternate locations may be considered. This position will work a hybrid ... of our Elevance Health PulsePoint locations. The ** Director of Medicare Risk Adjustment Analytics and Reporting** is responsible for planning, directing… more
- Point32Health (Canton, MA)
- …individual will be responsible for supporting critical data submission functions for the Risk Adjustment Department (RAD), including submissions to CMS and state ... timely resolution of production issues pertaining to state government and risk adjustment data submissions, including issue investigation, business requirements,… more
- Evolent (Boston, MA)
- …including plans related to medical expense management, quality improvement, appropriate risk adjustment , and patient and provider engagement. Members of ... Medicare in the Shared Savings Program. The Managing Director will report to the SVP Primary Care /...and Network teams. Additionally, the MD will oversee ECP's Risk Adjustment program, with responsibility for developing… more
- Molina Healthcare (Cambridge, MA)
- …etc.), set annual targets for each VBP/VBC in conjunction with national quality and risk adjustment VPs, develop and produce reports for Regional Directors and ... and must live in Massachusetts _** **Job Description** **Job Summary** The Director , LTSS Partnerships plays a critical role in the development and implementation… more
- Commonwealth Care Alliance (Boston, MA)
- …+ Maintain current industry knowledge of highly impactful external audits such as Risk Adjustment Data Validation Audit, CMS Program Audit protocols, common ... Risk Assessment. + Make recommendations towards enhancements to the Continuous Compliance Risk Assessment process. + Alert Director of Internal Audit of… more
- Commonwealth Care Alliance (Boston, MA)
- …and/or maintain current industry knowledge of highly impactful external audits such as Risk Adjustment Data Validation Audit, CMS Program Audit protocols, common ... 012100 CCA-Internal Audit **Position Summary:** Under direction of the Director of Internal Audit, the primary functions of this position are to: + Contribute… more