- Molina Healthcare (Rochester, NY)
- …**Job Summary** Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintain risk adjustment model, ... to identify risks. Additional leadership opportunities are available to lead national risk adjustment studies. Prior experience in Medicaid risk adjustment is… more
- Molina Healthcare (Yonkers, NY)
- **Job Description** **Job Summary** The Analyst, Risk Adjustment-Predictive Analytics role will support Molina's Risk Adjustment Predictive Analytics team. ... support Molina's Prospective and Retrospective Interventions. **Knowledge/Skills/Abilities** + Assist Risk Adjustment Data Analytics Leaders in Prospective and Retrospective… more
- Option Care Health (Albany, NY)
- …limited to FWA, Medicare & Medicaid billing requirements, and interactions with healthcare professionals. Lead or support risk assessments of business ... that attracts, hires and retains the best and brightest talent in healthcare . **Job Description Summary:** The Vice President, Compliance Business Partner is a… more
- Molina Healthcare (Syracuse, NY)
- **JOB DESCRIPTION** **Job Summary** Responsible for Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and reporting. ... various sources to identify risks. Maintain/update SQL model(s), estimate risk scores, and analyze impact. **KNOWLEDGE/SKILLS/ABILITIES** + Collaborate with… more
- Molina Healthcare (NY)
- **Job Description** **Job Summary** The Sr Analyst, Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops ... the initiatives. Educates users on how to use reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare/MMP. Assists with research,… more
- Molina Healthcare (Buffalo, NY)
- …risks effects. Identifies and analyzes potential sources of loss to minimize risk and estimates the potential financial consequences of an occurring loss. Through ... **Knowledge/Skills/Abilities** * Assist in the daily operations of all aspects of risk adjustment data validation related activities, including, but not limited to:… more
- Molina Healthcare (Buffalo, NY)
- …Summary** The Senior Analyst will serve a key role on the RADV ( Risk Adjustment Data Validation) team, contributing to the end-to-end data strategy and execution ... for audit response. + Collaborate with internal stakeholders-including IT, Risk Adjustment operations, clinical teams, and retrieval vendors-to ensure accurate… more
- Nuvance Health (Poughkeepsie, NY)
- …required for an optimal transition plan. Provides education to patient/families and the healthcare team. 9. High Risk Care Coordinators coordinate care for a ... plans in collaboration with patient, provider, and possible family and multidisciplinary healthcare team. Provides ongoing monitoring and evaluation of plans to meet… more
- Guthrie (Binghamton, NY)
- …C. Recognizes and identifies actual or potential situations which may place the healthcare system at risk for corporate compliance. Communicates appropriately to ... actions. N. Supports any environment that achieves employee satisfaction. Participates in risk management and crisis intervention. A. Acts as liaison to patients… more
- Bassett Healthcare (Cooperstown, NY)
- …Ensure that the department environment is free from recognized hazards that create a risk of injury to healthcare workers, patients, and/or visitors Support and ... and optimizing pharmacy services to meet the needs of patients and healthcare providers. This leadership role requires a strategic thinker with strong clinical… more