- Point32Health (Canton, MA)
- … programs are implemented and operated at the highest levels of performance. The Risk Adjustment Consultant will also work closely with our Network ... & Operations, this individual will support the operations and analysis of all risk adjustment programs and serve as the primary point of contact to a select… more
- Tufts Medicine (Burlington, MA)
- …coding meets both established coding standards as well as CMS and Commercial Risk Adjustment guidelines. This position has extensive knowledge of overall ... improve overall provider documentation as it pertains to coding and risk adjustment guidelines. Reviews medical records to determine if diagnostic codes… more
- PNC (Tysons Corner, VA)
- …opportunity to contribute to the company's success. As a Quantitative Analytics/Modeling Consultant within PNC's Model Risk Management organization, you can be ... validation of a mix of the following models: derivative pricing models, Value at Risk (VaR) models, asset and liability models measuring interest rate risk and… more
- Guidehouse (Atlanta, GA)
- …include actuarial modeling tasks such as developing healthcare projections, analyzing risk adjustment impacts, and designing and evaluating value-based contracts ... -sharing models for our clients. As an actuarial managing consultant , you will ensure quality deliverables are created and...other pilot program models + Capitation rate development + Risk adjustment calculations of premium + Development… more
- CVS Health (Hartford, CT)
- …Consultant within the Revenue Integrity COE organization, you will be leading Risk Adjustment technical activities, not limited to electronic medical record ... consultants, team members and/or matrixed staff as required to lead Risk Adjustment Revenue Integrity initiatives. Accountable for transferring knowledge,… more
- CVS Health (Hartford, CT)
- … Consultant within the Revenue Integrity organization, you will be leading Risk Adjustment technical activities, not limited to electronic medical record data ... members and/or matrixed staff as required to support ACA IFP Risk Adjustment Revenue Integrity initiatives. Responsible for leading the reconciliation of data… more
- Intermountain Health (Las Vegas, NV)
- …leaders, physicians, advanced practice providers (APP), and other staff about documentation and risk adjustment in order to improve the accuracy of the overall ... mentor to leaders, physicians, APP's, and other staff about documentation and risk adjustment . + Reviews medical records documentation for reimbursement,… more
- RELX INC (Boca Raton, FL)
- Business Consultant , Customer Engagement & Communication Are you creatively minded yet data and insight-driven? Do you enjoy being part of a team that delivers ... quality customer service? About the Business: LexisNexis Risk Solutions is the essential partner in the assessment of risk . Within our Business Services… more
- Wells Fargo (San Antonio, TX)
- …today. **About this role:** Wells Fargo is seeking a Lead Analytics Consultant in the Customer Remediation Center of Excellence supporting the Remediation Analytics ... that require remediation and to calculate the refund, account adjustment or other resolution. These roles will support Home...align to the enterprise. + Engage with peers, managers risk , compliance, managers across the enterprise, and serve as… more
- Health Advocates Network (Harrisburg, PA)
- …definitions for infectious syndromes; identify outcome data and exposure data; perform risk adjustment ; use benchmarking data to assess performance. Data ... Public Health Physician Consultant -Intermediate **Pay Rate:** $110 / hour "Working Title...CPSO, six-sigma, black belt, green belt), organizational transformation or risk management. Would also consider exceptional nurse practioners with… more
- RELX INC (Alpharetta, GA)
- About the Business LexisNexis Risk Solutions is the essential partner in the assessment of risk . Within our Business Services vertical, we offer a multitude of ... Laundering/Counter Terrorist Financing, Identity Authentication & Verification, Fraud and Credit Risk mitigation and Customer Data Management. You can learn more… more
- Virginia Mason Franciscan Health (Seattle, WA)
- …Plans, writes, develops and conducts on-going training regarding professional services and risk adjustment revenue and reimbursement. + Interprets changes in the ... experience as an instructor/trainer preferred. + Clinical knowledge and exposure to risk adjustment coding preferred. + Experience with Radiation Oncology… more
- RELX INC (Philadelphia, PA)
- Customer Success Consultant Are you passionate about driving Digital Transformation through innovative Data-as-a-Service (DaaS) solutions? Are you a skilled ... customer's Digital Transformation by serving high-quality data and analytics.The Customer Success Consultant (CSC) is a member of a team of Sales- and… more
- RELX INC (New York, NY)
- …manufacturers. About the Role Cirium Ascend Consultancy is seeking an enthusiastic Valuations Analyst/ Consultant to join our New York City OR European team. This is ... enriching both your professional and personal life. Responsibilities As a Valuations Analyst/ Consultant , you will help deliver projects as part of a highly… more
- Kaniksu Community Health (Sandpoint, ID)
- …to provide comprehensive care for patients. + Assist in the detection of "at risk " patients and develop plans to promote wellness. + Assist the integrated care team ... accordance with federal, state, and board regulations. As an Integrated Behavioral Health Consultant a typical day might include: + Apply solid working knowledge of… more
- Deloitte (Williamsville, NY)
- …+ Experience with Medicaid waivers (ie, 1115, 1915 b/c, 1332) + Experience with risk adjustment mechanisms + Experience with health care reform and working ... Capital practice. Work you'll do As a Government Health Actuary - Senior Consultant in Deloitte's Human Capital Actuarial and Insurance Solutions Practice, you will… more
- Sutter Health (Sacramento, CA)
- …across the system will be required as needed for this role. CRC (Certified Risk Adjustment Coder) is highly desired for this role. **EDUCATION:** Equivalent ... throughout the market/network/service line(s), ethics and compliance staff, and Legal & Risk Services team members regarding changes in federal and state laws and… more
- Virginia Mason Franciscan Health (Seattle, WA)
- …3 year of experience as an instructor/trainer. - Clinical knowledge and exposure to risk adjustment coding. - Experience with Radiation Oncology coding. We are ... an equal opportunity/affirmative action employer. #missioncritical **Pay Range** $31.94 - $53.66 /hour We are an equal opportunity/affirmative action employer. more
- Nebraska Public Power District (Columbus, NE)
- **Insurance & Risk Administrator** Location: Columbus, NE, US, 68602-0499 **Nebraska Public Power District (NPPD)** has an immediate opening for a **Insurance & ... Risk Administrator** located at **Columbus General Office** in **Columbus**...incumbent experience. **Essential Duties & Responsibilities** Act as a consultant , resource, and subject matter expert to the District… more
- Children's Aid (Bronx, NY)
- …Bonus Eligible** **Position Summary: FFT Therapists in the FFT-CW High Risk track **provide empirically documented, well-grounded, and highly successful family ... better match families to necessary behavior changes to address risk , needs, and safety. **FFT-CW** **(Child Welfare)** is a...Implement all FFT protocols as provided by the FFT consultant and/or FFT supervisor. * Administer the FFT treatment… more