- Datavant (Albany, NY)
- …mindset and a focus on continuous improvement. + Familiarity with CMS HCC risk adjustment processes preferred \#LI-BC1 We are committed to building a diverse ... in Business, Operations Management, or a related field; MBA or equivalent advanced degree preferred . + At least 8 to 10 years of experience in healthcare technology… more
- Molina Healthcare (Syracuse, NY)
- … management activities and clinical informatics + Experience with Risk Adjustment Data Validation ** Preferred License, Certification, Association** + Certified ... training and education to network of providers on how to improve their risk adjustment knowledge as well as provide coding updates related to Risk Adjustment … more
- Trinity Health (Albany, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** **Risk Adjustment Auditor Educator** -St. Peter's Health Partners - Full-time - Remote ... **POSITION PURPOSE:** A Risk Adjustment Auditor Educator is responsible for ensuring accurate coding and documentation in alignment with risk adjustment models,… more
- Evolent (Albany, NY)
- …Be Doing:** **Manager, Coding Support Specialist** Evolent Care Partners is seeking a Risk Adjustment Coding Support Manager to be a core member of the Risk ... Adjustment Coding Support team. Evolent Care Partners' mission is...problem-solving skills, and proficiency in clinical documentation requirements. **Qualifications Preferred :** + Clinical knowledge of chronic conditions and comorbidities.… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …you, we encourage you to apply! Job Description: Summary: The Risk Adjustment Coding Coordinator is responsible for various aspects of decision-making and ... to ensure accurate diagnosis coding. This position is responsible for risk adjustment coding and quality assurance validation for the following programs, including… more
- Molina Healthcare (NY)
- …will be responsible for work around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling of complex ... healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data to evaluate healthcare intervention program performance. Develops and presents… more
- Molina Healthcare (Yonkers, NY)
- …Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintain risk adjustment model, estimate ... identify risks. Additional leadership opportunities are available to lead national risk adjustment studies. Prior experience in Medicaid risk adjustment is not… more
- Datavant (Albany, NY)
- …for healthcare. **Role Overview** As the Director of Prospective + Concurrent Risk Adjustment Products, you will lead the strategy, roadmap, and execution for the ... and acting on undiagnosed conditions (prospective suspecting) and ensuring risk adjustment coding accuracy in near real-time (concurrent review). You will manage… more
- Molina Healthcare (Buffalo, NY)
- …* Assist in the daily operations of all aspects of risk adjustment data validation related activities, including, but not limited to: progress tracking, ... transmissions, and adherence to applicable timelines * Support all risk adjustment audit related projects to ensure goals, objectives, milestones and deliverables… more
- Molina Healthcare (Syracuse, NY)
- **JOB DESCRIPTION** **Job Summary** Responsible for Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and reporting. ... **KNOWLEDGE/SKILLS/ABILITIES** + Collaborate with Actuarial staff to calculate risk adjustment payment estimates. Document assumptions. + Analyze results to identify… more