- Datavant (Tallahassee, FL)
- …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
- Humana (Fort Lauderdale, FL)
- …+ Experience with public speaking and presentation skills with healthcare providers + Medicare Risk Adjustment knowledge **Additional Information** Work at ... 4 or more years of medical coding experience + Risk Adjustment knowledge + Proficiency with data...recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over… more
- Highmark Health (Tallahassee, FL)
- …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
- Humana (Tallahassee, FL)
- …innovator, and relationship builder, ensuring alignment with Humana's mission and Medicare Advantage goals. **Primary Responsibilities:** Clinical Engagement & ... understanding of clinical metrics and data (eg Quality measures, Risk Adjustment ratings, chronic condition management, PCP...recognized leader in healthcare delivery that has been offering Medicare Advantage health plans in Florida over… more
- CenterWell (Orlando, FL)
- …Coding Curriculums. In this role, you'll blend your clinical expertise-especially in Medicare Risk Adjustment (MRA) and HCC coding-with instructional ... + Design and develop provider education programs focused on clinical documentation, risk adjustment , and coding accuracy for value-based primary care. +… more
- CenterWell (Tampa, FL)
- …a value-based primary care setting. This role uses clinical expertise and knowledge of risk adjustment and coding to present educational materials in a way that ... clinicians, presenting education that aligns with value-based care priorities like risk adjustment accuracy, quality performance, compliance, and effective… more
- Deloitte (Tampa, FL)
- …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
- Elevance Health (Tampa, FL)
- …hospital medical records to ensure proper ICD-9 coding and compliance with risk adjustment requirements. **Location:** Virtual: This role enables associates to ... project and RADV. + Assists with National and Targeted Risk Adjustment Data Validation audits. + Participates...Coders or Practice Management Institute). + Experience working with Medicare Advantage and Medicaid preferred. + Experience… more
- ChenMed (Miami, FL)
- …information. Calculates statistical and probability forecasts and models from data. + Runs CMS risk adjustment model to calculate member level risk scores. + ... finance preferred + Minimumfive(5) years of related experience + Experience in Medicare Advantage preferred **PAY RANGE:** $108,313 - $154,733 Salary **EMPLOYEE… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …tools or analytics platforms preferred. + Familiarity with RFP tracking systems, Medicare Advantage , or value-based care models is highly desirable. Knowledge, ... solutions that span the entire member lifecycle--from enrollment and billing to risk adjustment , Stars performance, and member engagement. Pareto's deep… more
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