- Ankura (New York, NY)
- …operations, investigations, and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment . The Senior Director will also ... of activities: + Help clients manage proactive and reactive Medicare and Commercial Risk Adjustment compliance, audit, and investigation projects for clients. +… 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 ... on identifying and acting on undiagnosed conditions (prospective suspecting) and ensuring risk adjustment coding accuracy in near real-time (concurrent review).… more
- Molina Healthcare (Yonkers, NY)
- …monitoring, and oversight of all chart collection for HEDIS, or HEDIS-like projects, Risk Adjustment , Risk Adjustment Data Validation, and ... **Job Description** **Job Summary** The Director , Clinical Data Acquisition is responsible for the...that support business objectives. + HEDIS Operations experience. + Risk Adjustment and Data Validation experience. +… more
- Datavant (Albany, NY)
- …strategic mindset and a focus on continuous improvement. + Familiarity with CMS HCC risk adjustment processes preferred \#LI-BC1 We are committed to building a ... experiences to realize our bold vision for healthcare. The Director of Client Success will report to the VP...updates, etc.). + Identify project risks that impact the quality of our product and services delivery to clients,… more
- Ankura (New York, NY)
- …college/university + Current Registered Nurse license + Experience working for payors conducting risk adjustment reviews + Clinical experience in a variety of ... and mature their compliance programs, conduct program effectiveness reviews, and risk assessments, and perform compliance audits. We assist in-house and outside… more
- Evolent (Albany, NY)
- …You'll 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...progress note clinical documentation review. + Ensure compliance and quality for all coding practices maintaining high standards and… more
- Mount Sinai Health System (New York, NY)
- …CDQI, who will (1) be responsible for driving key population health goals including access, quality , utilization and accurate risk adjustment with a group of ... practices and (2) close partnership with the CDQI Director to drive accurate risk adjustment...hardwiring processes to drive excellence in efficiency of care, quality and accurate risk adjustment … more
- RiseBoro Homecare Inc. (Brooklyn, NY)
- ESSENTIAL DUTIES AND RESPONSIBILITIES The Associate Director , Clinical Services (ADCS) is responsible for task-managing Program Coordinators, Prevention Educators, ... Counseling to prevent the development of maladaptive behaviors, reduce risk factors, and strengthen protective factors. This team provides evidence-based… more
- Molina Healthcare (Albany, NY)
- …regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + Facilitates conformance to Medicare, Medicaid, NCQA… more
- TD Bank (New York, NY)
- …the P&L, Attribution, Balance Sheet, and Independent Pricing Verification and Valuation Adjustment processes for TD Securities. + Lead a small, high performing team ... achieve business and operational objectives, maintain effective practices and deliver quality service consistent with TDS business objectives. + Grow team expertise… more