- 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
- 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
- CVS Health (Albany, NY)
- …required. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) preferred. ... ICD codes that are submitted to the Centers for Medicare and Medicaid Services (CMS) for the purpose of... and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and… 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
- Mount Sinai Health System (New York, NY)
- …for driving key population health goals including access, quality, utilization and accurate risk adjustment with a group of practices and (2) close partnership ... with the CDQI Director to drive accurate risk adjustment throughout the system. This Medical...all populations served, especially our patients covered under a Medicare arrangement (MSSP or MA). The MD will report… more
- New York State Civil Service (Brooklyn, NY)
- …treatment teams to mitigate potential for infectious disease.* Developing infection control risk assessment and plan along with educational programs for staff and ... Hiring Rate ($10,852), Geographic Pay Differential ($35,000), and Downstate adjustment of $4,000. The posted job rate is the...on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal… more
- Deloitte (Rochester, NY)
- …care and fee-for-service, Medicaid policy, budget forecasting and fiscal analyses, and risk adjustment + Support business development efforts for Federal and ... waivers (ie, 1115, 1915 b/c, 1332) + Experience with risk adjustment mechanisms + Experience with Provider...individual medical and small group markets + Experience with Medicare products, including Medicare Advantage or … more
- New York State Civil Service (Staten Island, NY)
- …treatment planning.* Participating in multidisciplinary case discussions, high- risk reviews, and administrative meetings.* Maintaining clinical documentation ... will be required.This position is eligible for a Downstate adjustment of $4,000.NOTE: 1. In order to be eligible...on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal… more