- BlueCross BlueShield of Tennessee (Chattanooga, TN)
- The ** Risk Adjustment & Quality Division at BCBST** is seeking a skilled ** Risk Adjustment Medical Record Coder** to support our mission of ... this role, you will perform first\-pass reviews of member medical records to identify and capture active...accordance with BCBST policy\. **Preferred Qualifications:** + CRC \(Certified Risk Adjustment Coder\) certification is a plus\.… more
- Datavant (Nashville, TN)
- …impact to our health insurance clients. This primarily consists of risk adjustment analytics, healthcare medical records retrieval and chart review ... a very granular level + Provide full oversight to risk adjustment and quality related projects that...field preferred + 2-5 years' experience in Healthcare Technology, Medical Records or Health Information. Prior experience… more
- Elevance Health (Nashville, TN)
- ** Risk Adjustment Actuarial Analyst II - Advanced Analytics** **On-Site Requirement:** **Hybrid 1;** **This role requires associates to be in-office 1 - 2 days ... an accommodation is granted as required by law._ The ** Risk Adjustment Actuarial Analyst II - Advanced...bonus programs (unless covered by a collective bargaining agreement), medical , dental, vision, short and long term disability benefits,… more
- Wolters Kluwer (Nashville, TN)
- …| Wolters Kluwer (https://www.wolterskluwer.com/en/solutions/health-language)** **Coder Workbench Solution:** ** Risk Adjustment Software | Health Language ... or Central time zone, have a solid understanding of risk adjustment in the Healthcare Technology space,...role covers all new business, w/ a proven track record of success in sales. **Key Tasks: ** +… more
- Datavant (Nashville, TN)
- …for healthcare. As an HCC (Hierarchical Condition Category) coder you will review medical records to identify and code diagnoses using a standardized system, ... ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will...Review, analyze, and code diagnostic information in a patient's medical record based on client specific guidelines… more
- Datavant (Nashville, TN)
- …strategies. The ideal candidate will have a deep understanding of value-based care, risk adjustment , and the healthcare provider ecosystem ( risk -bearing ... as a trusted advisor, demonstrating a strong understanding of risk adjustment , HCC coding, and value-based care...providers (health systems, ACOs, IPAs, etc.). + Proven track record of exceeding sales quotas and driving revenue growth… more
- CVS Health (Nashville, TN)
- …and every day. **Position Summary** Responsible for performing audit and abstraction of medical records (provider and/or vendor) to identify and submit ICD codes ... Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and...Federal regulations and internal policies and procedures. + Utilize medical records to ensure support is documented… more
- Amazon (Charleston, TN)
- …referrals to outside medical providers as necessary. - Minimize the AA risk of injury through awareness, education, and proactive engagement. - Maintain all ... goals, Amazon is seeking an experienced and dynamic Onsite Medical Representative (OMR) to join our team. In this... providers as needed, and learn about OSHA regulations, risk , and analysis. The OMR will function as a… more
- Deloitte (Nashville, TN)
- …reimbursement, MS-DRG, APR-DRG, PSIs, HACs, POA, Vizient, Elixhauser, public profiling, and risk adjustment + Has strong interpersonal skills to collaborate with ... and tracks progress. Job Duties and Responsibilities: + Analyze medical records for inpatient and outpatient service...+ Knowledge of care delivery documentation systems and related medical record documents + Knowledge of age-specific… more
- Bristol Myers Squibb (Nashville, TN)
- …lives. Read more: careers.bms.com/working-with-us . **Summary:** The Cell Therapy MSL captures medical insights and acts as a clinical & scientific advisor to ... partners. Ensures applicable interactions are aligned with enterprise and medical strategies and ultimately serve to ensure patients have...by your state of residence; and, 3) a driving risk level deemed acceptable by the Company. + The… more
- Humana (Nashville, TN)
- …respective functions with a focus on Provider Engagement, Quality and Medicare Risk Adjustment . Represents the health plan externally and to ... is responsible for the overall success of Stars and Risk Adjustment strategy and performance within the...and ability to influence these arrangements. + Proven track record of driving performance improvement + Excellent communication skills,… more
- Datavant (Nashville, TN)
- …ability to collaborate cross-functionally in a fast-paced environment. Experience in healthcare and risk adjustment is a plus. **What You Will Do:** + **Contract ... **What Helps You Stand Out:** + Background in healthcare, healthcare operations, or risk adjustment . + Experience partnering with Sales, Client Success, and Deal… more
- Humana (Nashville, TN)
- …provider. The Senior Coding Educator is responsible for creating and executing the risk adjustment strategy for each provider groups. + Analyzes data and ... Professional Coder) Certification + 2 or more years of medical record review knowledge + Familiar with...(CRC) + Experience interacting with healthcare providers + Medicare Risk Adjustment knowledge + Analyzing data to… more
- BP Americas, Inc. (Murfreesboro, TN)
- …plant equipment to resolve accurate and normal operating conditions. Check and record operational data such as fluid levels, temperatures and pressures, compare to ... to make corrections as needed. + Review daily operating reports and other records to ensure specified operating characteristics in control of the plant equipment. +… more
- Valor Health (Nashville, TN)
- …presentations related to mental health diagnoses (eg, sleep, pain, adherence to medical regimen, adjustment to illness), psychosocial stressors, grief or phase ... are coping with health psychology presentations (eg, sleep, pain, adherence to medical regimen, adjustment to illness), psychosocial stressors, grief or phase… more
- Bristol Myers Squibb (Knoxville, TN)
- …regional thought leaders (RTLs) and community-based physicians/HCPs in private practice, medical groups practices, office staff, and other stakeholders in the ... scientific resources and publications to present information to HCPs and ensures medical accuracy. + Conducts in-office presentations (eg, lunch and learns) and… more
- Bristol Myers Squibb (Knoxville, TN)
- …regional thought leaders (RTLs) and community-based physicians/HCPs in private practice, medical groups practices, office staff, and other stakeholders in the ... scientific resources and publications to present information to HCPs and ensures medical accuracy. + Conducts in-office presentations (eg, lunch and learns) and… more
- Bristol Myers Squibb (Knoxville, TN)
- …with regional thought leaders (RTLs) and community-based physicians/HCPs in private practice, medical groups practices, office staff , and other stakeholders in the ... and publications to present information to HCPs and ensures medical accuracy . + Conducts in-office presentation s (...superior selling competencies , and proven sales performance track record of meeting or exceeding goals. + Demonstrated ability… more
- Amazon (Nashville, TN)
- …in Safety, Risk Management, or investigations with a proven track record of critical thinking ability. - 2+ years work experience involving DSPs, DA's, ... Description As a Risk Ops Specialist for High Severity Incidents (HSI),...have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support… more
- Amazon (Nashville, TN)
- …and manage competing priorities * Experience with process improvement methodologies * Track record of successful project delivery and risk management * Drive ... work focuses on preventing occupational illnesses and injuries through proactive risk management and scalable solutions. Key job responsibilities * Lead Industrial… more
