- Humana (Richmond, VA)
- …Finance, Business, Auditing, Actuarial + Certified Internal Auditor, CPA or CPC strongly preferred + Risk Adjustment knowledge + Experience with risk ... Management Lead acts as a consultant to the Risk Adjustment team leaders, as programs and initiatives are executed...in the **Eastern Standard Time (EST) Zone are strongly preferred ** to support alignment with team schedules and collaboration.… more
- Highmark Health (Richmond, VA)
- …of strategic initiatives, specifically focusing on the evolution of Risk Adjustment Accuracy Management (RAAM) and Highmark's clinical data strategy. Providing ... of relevant progressive strategic experience in lieu of Master's degree ** Preferred ** + Extensive knowledge of Health Insurance and/or Provider operations,… more
- Datavant (Richmond, VA)
- …serves as a working supervisor with oversight and management of Risk Adjustment team members. This includes monitoring production and quality of employees' work, ... ICD -9/10 + 2 years coding experience, required. + 2 years auditing experience, preferred + People Leader experience managing a team of employees. + Familiarity with… more
- Highmark Health (Richmond, VA)
- …Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation (RADV) Audits. Works closely with physicians, team members, ... Enterprise and leadership to identify and deliver high quality and accurate risk adjustment coding. Supports all Remote Patient Monitoring (RPM) risk adjustment … more
- Humana (Richmond, VA)
- …The Senior Coding Educator is responsible for creating and executing the risk adjustment strategy for each provider groups. + Analyzes data and reporting and ... leader, tailor's provider group webinars and discussions based on various Risk Adjustment topics. **Use your skills to make an impact** **Required Qualifications** +… more
- Fairfax County Sheriff's Office (Fairfax, VA)
- …rehabilitation plans for and presents written or oral recommendations for adjustment of behavior; Supervises and monitors community service requirements; schedules ... their families and related persons to determine the nature of the adjustment difficulty; Refers offenders/defendants to other agencies or facilities as needed and… more
- Datavant (Richmond, VA)
- …ideal candidate will have a deep understanding of value-based care, risk adjustment , and the healthcare provider ecosystem (risk-bearing providers, ACOs, IPAs, etc). ... Serve as a trusted advisor, demonstrating a strong understanding of risk adjustment , HCC coding, and value-based care operations. + Liaison account management… more
- Elevance Health (Norfolk, VA)
- …medical records to ensure proper ICD-9 coding and compliance with risk adjustment requirements. **Location:** Virtual: This role enables associates to work virtually ... both revenue project and RADV. + Assists with National and Targeted Risk Adjustment Data Validation audits. + Participates and represents the department in business… more
- Hensel Phelps (Tysons Corner, VA)
- …Suite, specifically Excel-based templates, ProjectSight, Primavera and AutoDesk Suite. ** Preferred Qualifications:** + Past internships in the construction industry ... are preferred , but not required. **Essential Duties:** + Support the...policies. Based on position location, a cost of living adjustment (COLA) may also be included (subject to periodic… more
- PNC (Tysons Corner, VA)
- …measurement models, such as Potential Future Exposure (PFE), Credit Valuation Adjustment (CVA), and Funding Valuation Adjustment (FVA). Key Responsibilities: ... required certifications/licensures needed to be successful in this position. ** Preferred Skills** Analytical Thinking, Credit Risks, Data Analytics, Financial… more