- Northeast Georgia Health System, Inc (Gainesville, GA)
- …enhance understanding of clinical documentation improvement goals to achieve risk adjustment strategic goals and objectivesCoordinate and deliver programs ... collaborative efforts to design and create content-specific internal and external risk adjustment training curriculum and programsShall set priorities for… more
- VNS Health (Manhattan, NY)
- OverviewAs the Clinical Manager for Risk Adjustment , you will be at the forefront of our mission to optimize clinical coding practices and enhance ... of workflow enhancements, changes, and new products. + Provides updates to Risk Adjustment Stakeholders on program clinical coding and audit activities. +… more
- The Cigna Group (Nashville, TN)
- **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 ...through the application of analytics approaches + Experience with risk adjustment , healthcare analytics, clinical … more
- VNS Health (Manhattan, NY)
- …irregularities evidencing deviations from coding protocols. Conducts chart review around Provider Risk Adjustment Activity and clinical documentation errors ... for process improvement for ensuring compliance. + Enterprise Wide Risk Adjustment Collaboration Activities and Initiatives and support Manager in driving… more
- Carle (Urbana, IL)
- Risk Adjustment Education Specialist - HYBRID + Department: FCC - Case Mgmt + Entity: FirstCarolinaCare + Job Category: Professional + Employment Type: Full - ... Requirements: None Email a Friend Save Save Apply Now Position Summary: The Risk Adjustment Education Specialist consults with providers and their office staff… more
- Fallon Health (Worcester, MA)
- …have shared ownership within the Analytics staff for product line(s) as assigned by the Risk Adjustment Operations and Analytics Manager and will be a SME ... nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences,...Summary of Purpose** : The primary role of the Risk Adjustment Analyst (RAA) will be to… more
- CenterWell (Carson City, NV)
- …our caring community and help us put health first** The Associate Director, Risk Adjustment oversees quality assurance audits of medical records, ICD-10-CM, CPT, ... and over government agencies. In addition, the Associate Director, Risk Adjustment oversees all medical coding education... ensures coding is accurate and properly supported by clinical documentation within the health record. Follows state and… more
- Fallon Health (Worcester, MA)
- …feedback and submit to Manager for provider education efforts + Update risk adjustment software with all relevant chart review observations + Meet or ... and report on FCHP patient charts for the purpose of validating regulatory Risk Adjustment scores. The Chart Review Specialist will collect diagnostic details… more
- Baylor Scott & White Health (Columbus, OH)
- …AMA and the Federal Register, and sharing knowledge with co-workers, as directed + Assists Risk Adjustment Auditor 2 or Manager with educator duties in the ... strategies and processes for lines of business subject to risk adjustment . **SALARY RANGE** The pay range...+ Knowledge of ICD-10-CM and CPT coding conventions, and clinical documentation + Knowledge of and compliance with standards… more
- Fallon Health (Worcester, MA)
- …the nation's top health plans for member experience, service, and clinical quality. We believe our individual differences, life experiences, knowledge, ... claims data, through forecasting, statistical analyses, trending, regression analyses, risk assessment, and utilization assessment. Identifies key issues and trends… more
- Healthfirst (NY)
- …strategies. + Works collaboratively across lines of businesses, such as finance, clinical , medical economics, operations, risk adjustment , and population ... one or more specific Medicare performance areas such as Risk Score Accuracy, Medicare Clinical Programming and...areas such as Risk Score Accuracy, Medicare Clinical Programming and Operations, Provider Performance, Medical and Pharmacy… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …ensure coding and clinical documentation accuracy and consistency. Collaborating with the Manager of Risk Adjustment Operations, this position will also ... is eligible in the following personas: E-Worker, Mobile and Resident The Risk Adjustment Senior Coding Quality Auditor & Educator provides education and training… more
- State of Maine, Bureau of Human Resources (Bangor, ME)
- Hospital Nurse III - Risk Manager Quality & Informatics Bangor , Maine , United States | Nursing | Full-time Apply by: Sept. 24, 2024 Apply with Linkedin Apply ... promotional candidates will follow contractual requirements. Job duties: The Risk Manager performs a variety of functions...activities related to the review and mitigation of serious clinical risk and safety incidents. Manages initiatives… more
- Vatica Health (Alpharetta, GA)
- …coding, healthcare billing, quality and Value Based Care measures and metrics. Risk Adjustment knowledge/experience is preferred. + Understanding of Medicare, ... The Manager of Clinical Operations leads and manages the Clinical Operations teams in multiple Metropolitan Service Areas (MSAs) to ensure their efficiency,… more
- SSM Health (MO)
- …the patient's clinical course and complexity to validateaccurate risk - adjustment for administrative metrics used in government incentive/penalty programs. ... designed to improve and/or ensure the accurate depiction of clinical services, patient's severity of illness, and risk... clinical services, patient's severity of illness, and risk of mortality. + Conducts audits on CDI reviews… more
- LA Care Health Plan (Los Angeles, CA)
- …Experience Required: At least 6 years of experience in HEDIS, quality improvement, risk adjustment analytics, research, or related work within a healthcare ... Manager , Clinical Quality Analytics (STARS, SQL)... Manager , Clinical Quality Analytics (STARS, SQL) Job Category: ...net required to achieve that purpose. Job Summary The Manager of Clinical Quality Analytics (MSA) is… more
- SSM Health (MO)
- …findings. + Utilizes auditing data, along with data analysts/liaisons, to improve risk adjustment measures and denial management processes within department. + ... is compliant with regulatory requirements and standards are maintained. Performs clinical audits within Care Transformation operations by supporting the Clinical… more
- The County of Los Angeles (Los Angeles, CA)
- …full professional level and under the general direction of a licensed clinical program manager , supervises and coordinates multidisciplinary and ancillary ... allocable to this class report to a higher-level licensed clinical program manager and are assigned to...health care setting involving problems of mental or emotional adjustment and the use of psychiatric consultation. Option II:… more
- CenterWell (Columbus, OH)
- …Must possess an active RN license + A minimum five years' experience in risk adjustment coding, auditing, and/or education, working with providers + CPC ... manager . + As a team leader in National Clinical Education team, be an ambassador for the team's...experience + Knowledge of EMR + In-depth knowledge of risk adjustment key performance indicators + Comprehensive… more
- The County of Los Angeles (Los Angeles, CA)
- …full professional level and under the general direction of a licensed clinical program manager , supervises and coordinates multidisciplinary and ancillary ... MENTAL HEALTH CLINICAL SUPERVISOR, CORRECTIONAL HEALTH Print (https://www.governmentjobs.com/careers/lacounty/jobs/newprint/4050609) Apply MENTAL HEALTH … more
