- Ankura (New York, NY)
- …assessment. + Apply innovative techniques to healthcare engagements including those related to Risk Adjustment . + Expand and build new products in a ... thought leader in healthcare topics like predictive analytic applications, risk adjustment , and value-based care. + Develop,...Ability to manage multiple concurrent projects. + Commitment to quality and working within a team. + Effective oral… more
- Molina Healthcare (Rochester, NY)
- …+ Coordinates accountabilities between segment and markets to drive performance in network, risk adjustment , and stars; single point of contact for escalations ... Plan Scorable Action Items (SAIs) to ensure performance and quality levels exist in line with Centers for Medicare...+ Works with staff and senior management to mitigate risk and develop/implement improvements across areas that impact Medicare… more
- Molina Healthcare (Syracuse, NY)
- **Job Description** **Job Summary** The AVP, Risk Adjustment Encounters is responsible for establishing enterprise-wide strategy, governance, and oversight of ... the integrity of enterprise revenue, and enabling the organization's overall risk adjustment strategy. Knowledge/Skills/Abilities + Responsible for encounters… more
- American Express (New York, NY)
- …strategic to executional activities, and the Capacity Manager must flex staffing adjustment decisions accordingly in close support of Director -level colleagues. ... creative community in service of delivering best-in-class creative that is high- quality , cost-efficient, and quick-to-market. The Senior Capacity Manager will report… more
- Centene Corporation (Queens, NY)
- …improvement opportunities. + Develop and refine Medicare contract models to incorporate RAF ( Risk Adjustment Factor) trends, Stars quality metrics, and ... improve quality outcomes, and achieve financial sustainability under CMS-aligned risk -based models. This position will be responsible for working with the VBP… more
- Citigroup (New York, NY)
- Working directly for the Head of Governance for the Adjustment Reduction and Data Automation program and closely with the Accountable Executive, the Program Manager ... technology to define scope, priorities, and success measures. + Develop high- quality governance materials, executive updates, and strategic summaries that clearly… more
- Humana (Albany, NY)
- …analyze large data sets + Knowledge of healthcare compliance, mainly primary care and risk adjustment , pharmacy knowledge a plus + Certified Coder (CPC, CRC, ... to assess, investigate, audit and validate the mitigation of compliance risk across the organization. This team ensures that healthcare providers align… more
- New York State Civil Service (New York, NY)
- …Insurance Frauds Bureau. The position will report directly to the Deputy Director of Investigative Support in the Insurance Frauds Bureau. The primary responsibility ... training;* Liaises with DFS business units including procurement, legal, risk , human resources, information technology, and facilities, and agencies essential… more
- New York State Civil Service (Albany, NY)
- …using different analytical and statistical approaches; * Reviews and monitors quality of data submissions by entities, monitors variances, identifies trends, and ... up data in coordination with the Virtual Currency Data Governance Director ;* Creates and maintains interactive Tableau dashboards for scalability, manageability,… more