- Universal Health Services, Inc. (Edinburg, TX)
- …Care Resources. Collaborate with our physicians to educate on proper coding, risk adjustment metrics, capture documentation, and follow quality protocols. ... events. Champion a comprehensive, coordinated model of care for Medicare -aged population on a Medicare Advantage Plan...of care for Medicare -aged population on a Medicare Advantage Plan and Medicaid population. Champions the Attestation… more
- Humana (Austin, TX)
- …Business, Finance, Health Care/Administration, RN or a related field + Experience with Medicare Risk Adjustment and/or medical coding + Proven organizational ... advance their goals related to interoperability, quality, value-based arrangements, and risk adjustment strategies. Recommend execution strategies and monitor… more
- CVS Health (Austin, TX)
- …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 (TX)
- …deadline: Jan 8, 2026 As a Program Manager II on the One Medical At - Risk team, you will be the primary builder of new and existing capabilities and programs ... aimed at improving health outcomes for our at- risk patient populations. Working within Amazon's mission to be...have a disability and need a workplace accommodation or adjustment during the application and hiring process, including support… more
- Ascension Health (Austin, TX)
- …ICD-10 coding experience, preferably in outpatient or primary care settings. + Experience with risk adjustment programs ( Medicare Advantage, ACO, ACA HHS, or ... Medicaid). + Strong understanding of HCC models and MEAT documentation requirements. + Proficient in EHR systems (Athena preferred) and coding platforms. + Experience in value-based care or population health environments. + Background working with analytics or… more
- Deloitte (Dallas, TX)
- …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
- Molina Healthcare (Austin, TX)
- …with setting annual targets for each VBP/VBC in conjunction with national quality and risk adjustment VPs, Regional Directors of Quality/ Risk , Director of ... revenue management, strategy, and compliance + Knowledge of value based programs, risk adjustment models, quality metrics such as HEDIS and STARS, knowledge… more
- Deloitte (Dallas, TX)
- …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
- Molina Healthcare (Austin, TX)
- …of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), ... performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina Healthcare **JOB QUALIFICATIONS** **Required… more
- Molina Healthcare (Fort Worth, TX)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... State (TX) Medical License, free of sanctions from Medicaid or Medicare . **Preferred Experience** * Peer Review, medical policy/procedure development, provider… more
