- CVS Health (Boston, MA)
- …Health Medicaid Plans. Reporting to the Lead Director of Medicaid Risk Adjustment , the Market Manager will work closely with cross-functional ... Risk Adjustment Coder (CRC) Prior experience in Risk Adjustment field/ Medicaid **Education** Bachelor's Degree required from an accredited four… more
- Point32Health (Canton, MA)
- …and Operations, this individual will support the operations and analysis of risk adjustment strategy across Point32Health business lines. The Data Analyst ... will assist in managing vendor relationships, monitoring risk adjustment program operations, performing detailed analysis and synthesizing results to develop… more
- Deloitte (Boston, MA)
- …product strategy + Reimbursement models - including value-based care/ACO modeling + Risk adjustment mechanisms + Familiarity with group insurance products ... Work you'll do As a Deloitte Consulting Health Actuary Manager in the Insurance practice of Deloitte's Human Capital...& Insurance Solutions practice works with finance, actuarial, and risk functions to help life insurance companies, property &… more
- Tufts Medicine (Boston, MA)
- …aligned with the Hospital Quality and Equity Incentive Program of the Massachusetts Medicaid 1115 Waiver. This work will spread across the Tufts Medicine Health ... Medical Officer for Quality, the Melrose Wakefield Hospital Senior Director Quality, Risk Management & Patient Safety and the Lowell General Hospital Vice President,… 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 ... + Contribute towards the maintenance and enhancement of an effective Compliance Risk Assessment Program + Project manage regulator and other external reviews as… 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 ... performance indicators. **Additional Responsibilities** + Support Corrective Action Plan (CAP) Manager in communicating on new and existing CAPs emerging from source… more
- Boston Public Schools (Boston, MA)
- …COSE at COSE PD and onboarding. Perform all related duties requested by the Manager of Compliance. .04 Compliance COSE Maintain a caseload proportionate to status as ... an array of services for students with disabilities and students placed at risk . Engage families as partners in planning, problem-solving, and assisting with school… more