- Molina Healthcare (Bellevue, WA)
- …Health Plan strategic analysis and planning and coordinates across business units on Risk Adjustment Program Valuation and Strategic/Scoreable Action Items ... analytic / programming tools as needed + Reporting includes Risk Adjustment program performance metrics,...risk models including the various CMS models for Medicare Advantage members, the HHS model for Commercial ACA… more
- CVS Health (Olympia, WA)
- …codes. + 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
- Molina Healthcare (Everett, WA)
- …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
- Humana (Olympia, WA)
- …in Medicare Advantage or Value-Based Care + AAPC CRC (Certified Risk Adjustment ) Certification + AAPC CDEO (Certified Documentation Expert Outpatient) ... + This role is part of Humana's driver safety program and therefore requires an individual to have a...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- CVS Health (Olympia, WA)
- …etc. + Knowledge of Medicare Advantage, chronic condition assessments, or risk adjustment documentation workflows + Proficiency in workforce analytics tools ... This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our… more