- Ankura (New York, NY)
- …master's degree from an accredited college/university + 8+ years of experience in Medicare Risk Adjustment operations, internal audit, or compliance either ... compliance, accreditations, operations, investigations, and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment . The… more
- Elevance Health (New Hyde Park, NY)
- …for completing projects and performing complex actuarial studies related to risk adjustment analytics in both the Medicaid and Medicare Advantage lines of ... Analyzes and develops SAS and SQL programming to support Medicaid and Medicare Advantage risk adjustment initiatives. + Performs data mining and data-driven… more
- Humana (Albany, NY)
- …ensure compliance with CMS guidelines-all while supporting Humana's Retail bid goals and Medicare Risk Adjustment requirements. This role requires strong ... supporting internal Humana partners. + Ensure compliance with CMS guidelines and Medicare Risk Adjustment standards. + Collaborate with Stars program teams… more
- Humana (Albany, NY)
- …in a health care and / or Insurance setting + Working knowledge of Medicare Risk Adjustment and/or Stars + Experience utilizing Articulate products ... LMS **Additional Information** This role will be responsible for supporting the Medicare Risk Adjustment Team within the Healthcare Quality Reporting and… more
- Humana (Albany, NY)
- …internal teams and vendors to resolve issues and maintain compliance with CMS and Medicare Risk Adjustment requirements. + Support auditing processes for ... ownership of critical claims operations that ensure compliance and accuracy for Medicare members. As a Senior Program Delivery Professional, you'll manage vendor… more
- MVP Health Care (Schenectady, NY)
- …innovative thinking and continuous improvement. To achieve this, we're looking for a ** Risk Adjustment Analyst** to join #TeamMVP. This is the opportunity for ... prospective and retrospective objectives in population health management including focus on Risk Adjustment efforts. + Design targeting based upon disparate data… more
- Datavant (Albany, NY)
- …and life experiences to realize our bold vision for healthcare. As an Auditor, HCC Risk Adjustment Coder, you will review medical records to identify and code ... using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical… more
- Intermountain Health (Albany, NY)
- **Job Description:** This Position is an entry-level role in Risk Adjustment and will learn to demonstrate general proficiency in the areas of Risk ... Coding for highly regulated government insurance programs such as Medicare Advantage (MA), Medicaid, and the Affordable Care Act...to ensure accurate coding practices according to general and risk adjustment coding guidelines as established by… more
- Amazon (New York, NY)
- …economics reporting and ad-hoc analysis relating to cost of care management - Medicare Risk score projections and premium estimation -Design and implement ... responsible primarily for several critical workstreams which include analysis of Medicare Advantage and Accountable Care Organization data, design and implement an… more
- New York State Civil Service (Brooklyn, NY)
- …NY Zip Code 11233 Duties Description NYCCC is recruiting a Director of Clinical Risk Management Department to oversee their Risk Management Department and will ... Center database.* Attending facility-wide committee meetings as a representative of the Risk Management Department* Serving as the Co-Chairperson of Risk … more