- Northeast Georgia Health System, Inc (Gainesville, GA)
- …of 5+ years experience with increasing responsibilities in developing and executing risk coding programs.Knowledge of, and experience with, utilizing EPIC ... Excel, PowerPoint and Word). Essential Tasks and ResponsibilitiesShall develop a comprehensive risk coding accuracy program and curriculum in dyad with matrix… more
- Cambia Health Solutions, Inc (Portland, OR)
- …Key Experience: Risk Adjustment Experience (MUST HAVE) Risk Coding - CRC Certification (MUST HAVE) Network Contracts experienceValue Based ... risk adjustment experience includingMinimum 4 years of experience in a HCC Coding Audit or Network Management roleEquivalent combination of education and… more
- Point32Health (Canton, MA)
- …and best practices; utilize this knowledge to recommend modifications to Point32Health's risk adjustment programs and provider engagement practices + Support the ... individual will support the operations and analysis of all risk adjustment programs and serve as the primary point...of contact to a select portion of our provider network . This includes strategically important business partners, such as… more
- Somatus (Mclean, VA)
- …+ Community engagement opportunities + And more! The Director, Medicare Risk Adjustment (MRA) will lead the execution strategy and implementation of the ... establish risk adjustment analytics such as predictive modeling for coding improvement opportunities, provider coding improvement opportunities, provider … more
- Humana (Columbus, OH)
- …responsible for driving provider performance programs, goals and improvement metrics for network providers and partnerships. The Engagement Professional is an ... Network Optimization, Clinical Services, Value-Based contracting, HEDIS and Risk Adjustment. Reporting to the Associate Director and/or Market Development… more
- Capital One (Mclean, VA)
- Center 1 (19052), United States of America, McLean, Virginia Manager, Cyber Risk & Analysis- Technology Audit (Hybrid) **Capital One's Audit function is a dedicated ... including critical technology functions, cloud-based infrastructure, emerging technology, cybersecurity, risk management, application, and third-party management, as well as… more
- Capital One (Mclean, VA)
- …security, network security, cyber security, data protection), information systems risk management, information systems auditing, or a combination + At least 1 ... Center 1 (19052), United States of America, McLean, Virginia Principal Associate Cyber Risk & Analysis, Technology Audit (Hybrid) Capital One's Audit function is a… more
- LA Care Health Plan (Los Angeles, CA)
- Provider Network Account Manager III Job Category: Administrative, HR, Business Professionals Department: Provider Network Management Location: Los Angeles, CA, ... to support the safety net required to achieve that purpose. Job Summary The Provider Network Account Manager III is responsible for all aspects of the LA Care (LAC)… more
- Centene Corporation (Wichita, KS)
- …Acts as a liaison between Tier II providers (large PCP groups not on risk contracts and providers with upside only incentives) and the health plan. Manages ... Network performance for assigned territory through a consultative/account management...approach. Drives provider performance improvement in the following areas: Risk /P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost and utilization,… more
- Centene Corporation (Salem, OR)
- …Acts as a liaison between Tier II providers (large PCP groups not on risk contracts and providers with upside only incentives) and the health plan. Manages ... Network performance for assigned territory through a consultative/account management...approach. Drives provider performance improvement in the following areas: Risk /P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost and utilization,… more
- Centene Corporation (Tallahassee, FL)
- …education, including writing and updating orientation materials + Manages Network performance for assigned territory through a consultative/account management ... performance + Drives provider performance improvement in the following areas: Risk /P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost and utilization, etc. +… more
- Point32Health (Canton, MA)
- …data, coding schemes (ICD-9/ICD-10, CPT/HCPCS, DRGs), and health status risk adjustment + Prior experience with Business Intelligence tools such as ... here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** Reporting to the Vice President of Network and Provider Performance Management, the Director of Network … more
- Colorado State University (Fort Collins, CO)
- …on06/16/2024 Description of Work Unit Billing and Coding The Billing and Coding department within the Health Network at Colorado State University ( CSUHN ... mission and vision of access, research, teaching, service, and engagement . Each member of our community has a responsibility...insurance companies, regulatory bodies, as well as internal Health Network departments to enable proper coding and… more
- Tufts Medicine (Burlington, MA)
- …through extensive interaction with physicians, nursing staff, other patient caregivers, and coding staff to ensure that documentation reflects the level of service ... conditions and procedures, for accurate representation of severity of illness, expected risk of mortality, and complexity of care of the patient through extensive… more
- LifePoint Health (Brentwood, TN)
- …in the clinic setting to capture an accurate representation of the severity of illness, risk adjustment and facilitate proper coding . This CDI role will focus on ... physicians, group practices, and administration. * Participate in continuing education for risk adjustment, CDI requirements, and coding guidelines. * Adhere to… more
- Capital One (Plano, TX)
- …growth and professional opportunity. Inspired by our colleagues, we are risk identifiers, challengers, influencers, and transformational leaders who drive impactful ... these insights to ensure the team maintains a comprehensive understanding of the risk profile of the audit universe. Each audit assignment enables the candidate to… more
- LifePoint Health (Brentwood, TN)
- …MSSP, ACO Promoting Interoperability), educating ACO/CIN providers on proper documentation and coding for accurate patient risk profiles (HCCs or other), and ... * Supervise the improvement of ACO/CIN provider documentation and coding accuracy for risk adjustment. * Serve...* Oversee strategic ACO/CIN projects related to quality improvement, risk adjustment, network development, and post-acute care… more
- Capgemini (Scottsdale, AZ)
- …access control (RBAC), entitlement management, and policy enforcement. + ** Network Security:** Understanding of network protocols, firewalls, intrusion ... detection systems, VPNs, and other network security technologies. + **Operating Systems:** Proficiency in various operating systems (Windows, Linux, Unix, etc.) and… more
- Mastercard (Tampa, FL)
- …meetings, knowing your people, managing career development, and understanding who is at risk * Provide and facilitate timely feedback, coaching in the moment, and ... Mastercard Way behaviors through their behavior, recognitions, coaching, and employee engagement * Manage and optimize budgets, forecasting, and cost allocation… more
- Erickson Living (Pompton Plains, NJ)
- …a neighborhood of Morris County, New Jersey. We're part of a growing network of communities developed and managed by Erickson Senior Living, a national provider ... payroll for the medical center + Coordinating training of staff and providers on coding and billing issues with the Managers of Reimbursement and Coding and… more
