• Medical Director Physician Engagement…

    Mount Sinai Health System (New York, NY)
    adjustment with a group of practices and (2) close partnership with the CDQI Director to drive accurate risk adjustment throughout the system. This ... the status quo **Role Summary:** MSHP seeks a Medical Director (MD), Physician Engagement and CDQI, who will (1)...drive excellence in efficiency of care, quality and accurate risk adjustment for all populations served, especially… more
    Mount Sinai Health System (03/04/25)
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  • Medical Director (New York)

    Molina Healthcare (New York, NY)
    …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 (03/04/25)
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  • Coding Specialist

    VNS Health (Manhattan, NY)
    …reimbursement related issues; makes coding and documentation recommendations for adherence to risk adjustment models. + Reviews medical documentation to ensure ... documentation is accurate, precise, and adherent to CMS guidelines pertinent to Risk Adjustment Hierarchical Condition Category (HCC) methodology. + Assigns… more
    VNS Health (02/11/25)
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  • Reg Mgr, Value-Based Prgms

    Molina Healthcare (New York, NY)
    …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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