- Datavant (Sacramento, CA)
- …with the teams to improve productivity and quality.** + Run various risk adjustment models for Medicare Advantage , Medicaid or ACA to forecast patient ... and life experiences to realize our bold vision for healthcare. The Risk Adjustment Sr Data Analyst is an experienced analyst possessing a deep understanding… more
- Amazon (San Francisco, CA)
- …will responsible primarily for several critical workstreams which include analysis of Medicare Advantage and Accountable Care Organization data, design and ... TME performance compared to plan expectations. Key job responsibilities -Analysis of Medicare Advantage and Accountable Care Organization data primarily -Medical… more
- Highmark Health (Sacramento, CA)
- …and its beneficiaries enrolled in Risk Adjusted government programs such as Medicare Advantage (MA) and Affordable Care Act (ACA), using skills including but ... Centers for Medicare and Medicaid Services (CMS) coding guidelines, and Risk Adjustment Data Validation (RADV) Audits. Works closely with physicians, team… more
- UCLA Health (Los Angeles, CA)
- …Triennial Review, pre-delegation reviews, and more. * Design and improve audit toolkits based on Medicare Advantage and Part D risk areas. * Collaborate with ... our team as a Compliance Auditor, MAPD, focused on Medicare Advantage (Part C) and Prescription Drug...D) programs. In this vital role, you will conduct Risk Adjustment Data Validation (RADV) audits, compliance… more
- Deloitte (Los Angeles, CA)
- …reimbursement, MS-DRG, APR-DRG, PSIs, HACs, POA, Vizient, Elixhauser, public profiling, and risk adjustment + Has strong interpersonal skills to collaborate with ... Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk & Forensic team helps client leaders translate multifaceted risk … more
- Sutter Health (Sacramento, CA)
- …contracts, ensuring accurate setup in collaboration with Operations and MCF.** + **Validate CMS Medicare Advantage and ACA risk scores, along with payer ... finance foundation and solid understanding of provider reimbursement principles-such as risk adjustment , capitation, and fee-for-service-who can apply this… more