- 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
- Molina Healthcare (Buffalo, NY)
- …**Knowledge/Skills/Abilities** * Assist in the daily operations of all aspects of risk adjustment data validation related activities, including, but not limited ... retrieval, file transmissions, and adherence to applicable timelines * Support all risk adjustment audit related projects to ensure goals, objectives, milestones… 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
- Molina Healthcare (NY)
- …Azure, AWS, or Hadoop + 3-5 years of experience in Analysis related to HEDIS and/or Risk Adjustment + 3-5 years of experience in working with complex data to ... Educates users on how to use reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare... Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare /MMP. Assists with research, development, and completion of special… more
- Molina Healthcare (Syracuse, NY)
- …Health Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities. Ensures ... Plan have engagement plans to meet annual quality and risk adjustment goals. Drives coaching and collaboration...Min 3 years experience improving Quality performance for Medicaid, Medicare , and/or ACA Marketplace programs To all current Molina… more
- New York State Civil Service (Bronx, NY)
- …NY Zip Code 10461 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
- New York State Civil Service (Bedford Hills, NY)
- …and/or chemical abuse programs, specialized assessment (functional, personality, risk , competency, vocational, education); design and application of behavioral ... be required.This position is eligible for a Down State adjustment of $4,000.This position is at Central New York...on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal… more
- Molina Healthcare (Rochester, NY)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... medical director, and quality improvement staff. + Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews quality referred… more
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