• Value-Based Reimbursement Specialist

    Highmark Health (Hartford, CT)
    …goals including but not limited to Government Markets (STARS, ACA, CHIP, Medicaid DE) and Enterprise Quality, Safety, and Values (Health Outcomes Measures). Provide ... share models and will be implemented for the Organization's Medicare Advantage, Medicaid , ACA, and commercial populations with the goal of maximizing quality while… more
    Highmark Health (02/25/25)
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  • Hierarchical Condition Category (HCC) Coding…

    Highmark Health (Hartford, CT)
    …medical coding, clinical terminology and anatomy/physiology, Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation ... Professional Coder (CPC) + Certified Risk Coder (CRC) + Certified Coding Specialist (CCS) + Registered Health Information Technician (RHIT) **Preferred** + None… more
    Highmark Health (03/04/25)
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  • Special Investigation Unit Coding Director (Aetna…

    CVS Health (Hartford, CT)
    …providing guidance and support to maintain compliance with Medicare and Medicaid regulations. Your expertise will be crucial in optimizing coding processes ... diagnoses in compliance with federal and state regulations, including Medicare and Medicaid guidelines. * Develop and implement efficient coding workflows to enhance… more
    CVS Health (02/21/25)
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  • Field Medical Director, Interventional Cardiology…

    Evolent (Hartford, CT)
    …Join our Utilization Management team as a Field Medical Director, Cardiovascular Specialist and use your expertise in interventional cardiology to help ensure the ... for Initial Clinical Reviewers, offering guidance and expertise to ensure the application of best practices. + Provides clinical rationale for standard and expedited… more
    Evolent (01/30/25)
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