- Baylor Scott & White Health (Austin, TX)
- …internal and external sources to provide insight to decision-makers. This role supports program management activities around risk adjustment data management ... + **JOB SUMMARY** The Risk Adjustment Analyst Sr is responsible...such as revenue forecasting and ROI. + Contributes to program improvement by designing and implementing business process and… more
- Molina Healthcare (San Antonio, TX)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... and effective resource management. + Develops and implements a Utilization Management program and action plan, which includes strategies that ensure a high quality… more
- Health Care Service Corporation (Richardson, TX)
- …key performance indicators, trends, and financial acumen + Knowledge of Medicare Stars, Medicare Risk Adjustment , and Medicare Finance. + Strong ... the team to support divisional short and long-term initiatives related to Medicare provider network strategy and leverage analytics to drive provider network… 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 (Houston, TX)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... in line with industry standards and best practices * Assists with new program implementation and supports the health plan in-source BH services * Additional duties… more
- Health Care Service Corporation (Harlingen, TX)
- …provider trainings on health plan coding initiative guidelines and requirements of the Risk Adjustment program to ensure correct coding and documentation. ... Experience in health insurance or health care setting + Previous experience working on Risk Adjustment coding for either Medicare Advantage or Retail… more
- Humana (Austin, TX)
- …processes, reporting, and visualizations for all Humana Healthy Horizons Medicaid Risk Adjustment , prospective programs, and interoperability. Takes initiative ... Managed Care + Experience in Medicaid + Experience in risk adjustment + Experience with data mining...+ Parental and caregiver leave + Employee charity matching program + Network Resource Groups (NRGs) + Career development… more
- CenterWell (Fort Worth, TX)
- …(clinical, financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and clinical ... performance improvement and coaching initiatives are precise *Identify critical issues for high- risk patients during case reviews & other forums, and modeling and… more
- CenterWell (Arlington, TX)
- …(clinical, financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and clinical ... improvement and coaching initiatives are precise + Identify critical issues for high- risk patients during case reviews & other forums, and modeling and driving… more
- CVS Health (Austin, TX)
- …consulting, financial strategic analysis. + Understanding of value-based care, including risk adjustment methodologies (eg, HCC coding), quality measurement ... development of provider performance improvement initiatives + Establish a program management framework for VBC improvement initiatives-- monitoring the impact… more