• Risk Adjustment Compliance…

    Humana (Columbus, OH)
    …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)
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  • IPA Coding Associate Director

    CenterWell (Columbus, OH)
    …+ 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)
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  • Medical Director (Marketplace)

    Molina Healthcare (Columbus, OH)
    …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)
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  • Reg Mgr, Value-Based Prgms

    Molina Healthcare (Columbus, OH)
    …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)
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