- Molina Healthcare (Yonkers, NY)
- …: + Experience in healthcare provider engagement or payer-provider program management . + Familiarity with clinical, quality, or risk adjustment program ... - Provider Engagement** plays a key role in driving risk adjustment and quality performance outcomes through effective program...SKILLS & ABILITIES** : + 3-5 years of program/project management or healthcare operations experience. + Strong… more
- Molina Healthcare (Syracuse, NY)
- …Condition Categories) Risk Adjustment Model + Background in supporting risk adjustment management activities and clinical informatics + Experience with ... codes are reported accurately to maintain compliance and to minimize risk and denials. **KNOWLEDGE/SKILLS/ABILITIES** + Performs on-going chart reviews and abstracts… 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 (Yonkers, NY)
- …monitoring, and oversight of all chart collection for HEDIS, or HEDIS-like projects, Risk Adjustment, Risk Adjustment Data Validation, and other state specific ... Electronic Medical Record (EMR) access. This position would oversee management of training for all CDA team members as...are aligned with effective practices as identified in the healthcare quality improvement literature and within Molina plans. +… 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
- Highmark Health (Buffalo, NY)
- … or Healthcare related industry + 3 years overseeing privacy, risk , audit, and/or compliance teams **Preferred** + 3 years with contract negotiations **LICENSES ... :** **JOB SUMMARY** This job is responsible for the day-to-day direction of all risk and compliance assessment activities of Highmark Health across a broad range of… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Clinical Risk Manager in the Department of Risk Management and Patient Safety is responsible for the day to day risk ... activities for The Mount Sinai Health System, including investigating, managing and analyzing risk management data; complying with risk management … more
- CVS Health (Albany, NY)
- …2-3 years' experience in Healthcare , with a focus on third party risk management , finance, compliance, or audit. + Proficiency with Microsoft Word, Outlook, ... each and every day. **Position Summary** Join CVS Health's Enterprise Third Party Risk Management (ETPRM) team as a Senior Analyst, where you'll help drive … more
- Sumitomo Pharma (Albany, NY)
- …event coding, concomitant medication coding, and causality statements. + Contributes to Risk Management Plans (RMPs)/ Risk Evaluation and Mitigation Strategy ... in oncology is highly desired + **Advanced understanding of pharmacovigilance and risk management regulations and guidelines, including pre- and post-marketing… more
- Capgemini (New York, NY)
- **Job Title:** Senior Senior Service Management Consultant - ServiceNow Business Analyst (SME) - Security, Risk , & Finance and Supply Chain **Location:** ... near NY City area; Atlanta, GA** **Travel:** 25% **Job Description:** A Security, Risk , & Finance and Supply Chain Subject Matter Expert (SME) has expertise and… more