- Elevance Health (Tampa, FL)
- ** Risk Adjustment Actuarial Analyst II - Advanced Analytics** **On-Site Requirement:** **Hybrid 1;** **This role requires associates to be in-office 1 - 2 ... granted as required by law._ The ** Risk Adjustment Actuarial Analyst II - Advanced Analytics**...performing complex actuarial studies related to risk adjustment analytics in both the Medicaid and Medicare… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …company seeks a highly skilled and results-driven Senior Product Manager to lead our Medicare Advantage Risk Adjustment solution portfolio. In this critical ... role, you will drive the strategic planning, development, and optimization of our Medicare Advantage Risk Adjustment solution, ensuring that our deliverables… more
- Molina Healthcare (FL)
- …of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), ... ability to convert observations into actions/interventions to improve financial performance. * Advanced understanding of Medicaid and Medicare programs or other… more
- Deloitte (Tampa, FL)
- …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
- Humana (Alachua, FL)
- …community and help us put health first** The Medical Record Retrieval Specialist ( Risk Adjustment Representative 3) Travels to provider offices within the region ... The records are reviewed by Humana's Coding staff. The Medical Record Retrieval Representative ( Risk Adjustment Representative 3): + Travel up to 60% of the time… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …cross-functional teams. + Strong understanding of the healthcare payer landscape, with Risk Adjustment experience highly preferred. + Proven experience in ... degree in finance, Business, Economics, or a related field; an advanced degree in Business, Information Technology, or Healthcare Administration is preferred.… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …solutions that span the entire member lifecycle--from enrollment and billing to risk adjustment , Stars performance, and member engagement. Pareto's deep ... or analytics platforms preferred. + Familiarity with RFP tracking systems, Medicare Advantage, or value-based care models is highly desirable. Knowledge, Skills,… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …solutions that span the entire member lifecycle--from enrollment and billing to risk adjustment , Stars performance, and member engagement. Pareto's deep ... and proactively develop effective and practical legal strategies and solutions to address risk + Create processes for and manage compliance with securities rules and… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …solutions that span the entire member lifecycle--from enrollment and billing to risk adjustment , Stars performance, and member engagement. Pareto's deep ... Console (Glue, Iceberg, EMR, IAM governance) + Jupyter/Python IDE ( advanced notebook-based development) + Lucidchart (platform-wide architecture diagrams) +… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …solutions that span the entire member lifecycle--from enrollment and billing to risk adjustment , Stars performance, and member engagement. Pareto's deep ... Advisory Analysts are key members of this mission-immersing themselves in advanced data analytics, modeling, and problem-solving to drive measurable client outcomes.… more