- CVS Health (Blue Bell, PA)
- …personal, convenient and affordable. Aetna has an exciting opportunity for a Program Manager to join our Risk Adjustment Retrospective Program for ... project manager and subject matter expert in Risk Adjustment chart retrieval & coding programs...+ Strong written and verbal communication. **Preferred Qualifications** + Risk adjustment program experience within… more
- The Cigna Group (Philadelphia, PA)
- **Summary** The Risk Adjustment Reporting & Analytics Manager is an opportunity to lead complex analytics projects and initiatives for Cigna's Medicare ... Advantage Risk Adjustment business. The Manager ...for employment unless they enter a qualifying smoking cessation program prior to the start of their employment. These… more
- St. Luke's University Health Network (Easton, PA)
- …to pay for health care. The Registered Nurse or Social Worker Care Manager is responsible for coordinating the complex discharge planning needs of patients, as ... patient as healthy as possible in the outpatient setting, minimizing the risk of readmissions. + Issues applicable state/federal regulatory notices as applicable… more
- RELX INC (Philadelphia, PA)
- Manager Incident Response Are you a skilled Cyber Security Strategist? Are looking for an innovative Cyber Security Leadership Role? About our TeamThis team secures ... Leadership role you will help growand execute our digital forensics program . You will be entrusted with running multiple investigations simultaneously.… more
- Deloitte (Philadelphia, PA)
- …with Medicaid waivers (ie, 1115, 1915 b/c, 1332) + 1+ years experience with risk adjustment mechanisms + 1+ years experience with Provider reimbursement streams ... Work you'll do As a Deloitte Consulting Health Actuary Manager in Deloitte's GPS Human Capital Actuarial and Insurance...be eligible to participate in a discretionary annual incentive program , subject to the rules governing the program… more
- CVS Health (Trenton, NJ)
- …Informatics Developer within the Revenue Integrity organization, you will be leading Risk Adjustment technical activities, not limited to electronic medical ... and/or matrixed staff as required to support ACA IFP Risk Adjustment Revenue Integrity initiatives. + Responsible...to maximize results; customize ACA reporting views and outreach manager data needed for day to day operations work.… more
- RELX INC (Philadelphia, PA)
- …to show value and insights while communicating with customers? About the Business LexisNexis Risk Solutions is the essential partner in the assessment of risk . ... drive insights from complex data sets, improving operation efficiency, increasing program integrity, discovering, and recovering revenue, and making timely and… more
- CenterWell (Trenton, NJ)
- …Must possess an active RN license + A minimum five years' experience in risk adjustment coding, auditing, and/or education, working with providers + CPC ... other clinical education projects and programs as needed, as program or project manager . + As a...experience + Knowledge of EMR + In-depth knowledge of risk adjustment key performance indicators + Comprehensive… more
- Travelers Insurance Company (Blue Bell, PA)
- …of employment. As part of our comprehensive compensation and benefits program , employees are also eligible for performance-based cash incentive awards. **Salary ... facts or allegations of each case. + Consults with Manager on use of Claim Coverage Counsel as needed....activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators,… more
- Travelers Insurance Company (Blue Bell, PA)
- …of employment. As part of our comprehensive compensation and benefits program , employees are also eligible for performance-based cash incentive awards. **Salary ... facts or allegations of each case. + Consults with Manager on use of Claim Coverage Counsel as needed....activities required to effectively evaluate claims, such as Subrogation, Risk Control, nurse consultants, and fire or fraud investigators,… more
- EMCOR Group (Kennett Square, PA)
- …failure. The employee has impact and influence on campus policy and program development. **Essential Duties and Responsibilities:** + Design and/or evaluate HVAC ... when necessary, the Lead Technician or Maintenance Technician III in repair, adjustment and maintenance of refrigerants, heat exchangers, HVAC equipment and systems,… more
- Sedgwick (Trenton, NJ)
- …written communication. + Develops contacts with company managers to introduce program ; represents client. + Contacts employers to determine specific information ... trends. + Maintains regular contact with clients following placement, as per program guidelines; contacts involved individuals regarding progress on each case and… more
- RELX INC (Philadelphia, PA)
- …AI based clinical decision support product? About the role: Principal Product Manager will lead product strategy, planning, and execution for our award-winning ... opportunities early + Be capable of driving an organizational culture of risk taking with "just enough" hypothesis-testing and data-driven decision making Work in… more