- Datavant (Albany, NY)
- …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
- Molina Healthcare (Albany, NY)
- …and development ad-hoc as well as automated analytical modules related to Risk Adjustment for Medicaid, Marketplace and Medicare /MMP. + Assist Risk ... **Job Description** **Job Summary** The Lead, Risk Adjustment - Predictive Analytics role...like Python and R programming would be an added advantage . + 5+ Years of experience in Analysis related… more
- Amazon (New York, NY)
- …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 (Albany, NY)
- …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
- Excellus BlueCross BlueShield (Rochester, NY)
- …and external to ensure accuracy. Leads preparation reporting, valuation, and forecasting of risk adjustment scores and revenue to support partners internal and ... + Leads preparation of accruals/liabilities for CMS Part D risk sharing and Part C revenue settlements. + Leads...statements for assigned business segments. + Leads preparation of Medicare Advantage bids and coordinates CMS bid… more
- Deloitte (New York, NY)
- …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
- New York State Civil Service (Newburgh, NY)
- …develop, train, and monitor implementation of behavioral assessments, behavior and high- risk behavior support plans, and medication monitoring plans for individuals ... includes the sum of statutory hiring rate for PS&T Grade 23 ($86,681) and Mid-Hudson adjustment ($2,000). The Mid-Hudson adjustment is also added to the job rate… more
- New York State Civil Service (NY)
- …treatment and expert testimony. * Specialized assessment (functional, personality, risk , competency, vocational, education) * Design and application of behavioral ... hiring rate ($25,077), Geographic Pay Differential ($20,000), and Downstate adjustment ($4,000). The Geographic Pay Differential and Downstate adjustment… more