- Ankura (New York, NY)
- …investigations, and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment . The Senior Director will also support ... master's degree from an accredited college/university + 8+ years of experience in Medicare Risk Adjustment operations, internal audit, or compliance either… more
- Mount Sinai Health System (New York, NY)
- …adjustment with a group of practices and (2) close partnership with the CDQI Director to drive accurate risk adjustment throughout the system. This ... hardwiring processes to drive excellence in efficiency of care, quality and accurate risk adjustment for all populations served, especially our patients covered… more
- Molina Healthcare (Albany, NY)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare ,… more
- Molina Healthcare (Buffalo, NY)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... Psychiatry **REQUIRED EXPERIENCE:** * 2 years previous experience as a Medical Director in clinical practice * 3 years' experience in Utilization/Quality Program… more
- New York State Civil Service (Brooklyn, NY)
- …Street City Brooklyn State NY Zip Code 11233 Duties Description NYCCC is recruiting a Director of Clinical Risk Management Department to oversee their Risk ... the Clinical Risk Managers (CRM) assigned to the department. The Director will have on-call and recall responsibilities along with evening work hours. The… more
- Molina Healthcare (Yonkers, NY)
- …with national quality and risk adjustment VPs, Regional Directors of Quality/ Risk , Director of Value Based Programs, and local health plan resources. + ... revenue management, strategy, and compliance + Knowledge of value based programs, risk adjustment models, quality metrics such as HEDIS and STARS, knowledge… more