- Elevance Health (New Hyde Park, NY)
- ** Medicare Risk Adjustment Actuarial Analyst III** **On-Site Requirement: Hybrid 1;** **This role requires associates to be in-office 1 - 2 days per ... employment, unless an accommodation is granted as required by law._ The ** Medicare Risk Adjustment Actuarial Analyst III** is responsible for completing… more
- Datavant (Albany, NY)
- …and managing in a remote environment (2+ years) + 3+ years of experience working with Medicare , ACA, and/or Medicaid risk adjustment models + 5+ years of ... realize our bold vision for healthcare. **What we're looking for:** The incoming Risk Adjustment Analytics Manager will be stepping into a role on the Business… more
- CenterWell (Albany, NY)
- …+ Ability to travel up to 20% **Preferred Qualifications** + Proven experience with Medicare Advantage risk adjustment functions. + Proven track record of ... entities within the Primary Care Organization. **Strategy:** + In partnership with AVP, Risk Adjustment and AVP, MRA Strategy, responsible for driving ongoing… more
- Datavant (Albany, NY)
- …outpatient or inpatient setting. + Current CCS, CRC, or CPC required. + Previous Medicare Advantage Risk Adjustment , CDI, Medicaid, Commercial RA, and HEDIS ... up to date with current coding policies for ICD-10, Medicare Advantage, HHS (ACA), and other markets. + Provide...clients understand the shifts and trends happening in the risk adjustment coding space. **What you will… more
- Centene Corporation (Queens, NY)
- …+ Develop and refine Medicare contract models to incorporate RAF ( Risk Adjustment Factor) trends, Stars quality metrics, and benchmarking methodologies to ... execution of the organization's Value-Based Payment strategies (VBP) and other risk -based contracting strategies. + Oversee Medicare -specific VBP contracts,… more
- Trinity Health (Syracuse, NY)
- …to conduct Education if needed. Auditing Experience Posting **POSITION PURPOSE:** A Risk Adjustment Auditor Educator is responsible for ensuring accurate coding ... and documentation in alignment with risk adjustment models, conducting audits with analysis...specialist with a solid background in value-based plans (VBP), Medicare Advantage (MA) and Medicare shared savings… more
- Molina Healthcare (Syracuse, NY)
- …role will be responsible for work around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling ... complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data to evaluate healthcare...risk models including the various CMS models for Medicare Advantage members, the HHS model for Commercial ACA… more
- Trinity Health (Albany, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** Risk Adjustment Coding Specialist -St. Peter's Health Partners - Full-time - Remote ... **POSITION PURPOSE:** The Risk Adjustment Coding Specialist works in a...adhering to coding guidelines established by the Centers for Medicare and Medicaid Services (CMS). **SKILLS, KNOWLEDGE, EDUCATION AND… more
- Datavant (Albany, NY)
- …to realize our bold vision for healthcare. **Role Overview** As a Product Manager, Risk Adjustment Analytics Products, you will contribute to the strategy and ... execution of analytics capabilities that power Datavant's risk adjustment solutions. You'll drive the development of robust, scalable, and actionable analytics… more
- CVS Health (Albany, NY)
- …regulatory compliance. + Serve as a subject matter expert on CMS regulations, risk adjustment , and revenue optimization. + Collaborate with internal stakeholders ... CMS Part C/D operations. + 5+ years' experience working with CMS regulations, risk adjustment methodologies, and revenue management. + 5+ years' experience… more