- Molina Healthcare (NY)
- …role will be responsible for work around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling ... complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data to evaluate healthcare...risk models including the various CMS models for Medicare Advantage members, the HHS model for Commercial ACA… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …right for you, we encourage you to apply! Job Description: Summary: The Risk Adjustment Coding Coordinator is responsible for various aspects of decision-making ... coding policies to ensure accurate diagnosis coding. This position is responsible for risk adjustment coding and quality assurance validation for the following… more
- Ankura (New York, NY)
- …deliver work and seeks to gain additional opportunities for development in a variety of risk adjustment related areas. Qualifications: + Certified in Risk ... Coding (CRC) with at least five (5) recent years of experience in HCC/ Risk Adjustment and/or RADV Audit Methodology + Associate's or Bachelor's degree… more
- Healthfirst (NY)
- …from an accredited institution. + At least 5 years previous work experience within risk adjustment + Credentialed Associate of the Society of Actuaries (ASA) + ... supporting Product and Actuarial analytical requests. + Experience with CMS/HHS risk adjustment payment methodologies. + Self-motivated, creative problem solver… more
- Datavant (Albany, NY)
- …outpatient or inpatient setting. + Current CCS, CRC, or CPC required. + Previous Medicare Advantage Risk Adjustment , CDI, Medicaid, Commercial RA, and HEDIS ... up to date with current coding policies for ICD-10, Medicare Advantage, HHS (ACA), and other markets. + Provide...clients understand the shifts and trends happening in the risk adjustment coding space. **What you will… more
- New York State Civil Service (Hauppauge, NY)
- …Crisis Team Meetings* Write Meeting Minutes for Crisis Team meetings* Attend Weekly High- Risk Meetings* Record High Risk meeting minutes* Prepare weekly High- ... for sending to outside teams* Copy and distribute High Risk presentation packets to perspective HRC members* Send out...experience. Candidates hired at the trainee level will be advanced to the full performance level following the successful… more