- Elevance Health (Waukesha, WI)
- ** Medicare Risk Adjustment Advanced...creating a culture that is designed to advance our strategy but will also lead to personal and professional ... an accommodation is granted as required by law._ The ** Medicare Risk Adjustment Advanced Analytics...of our culture. They are how we achieve our strategy , power our business outcomes and drive our shared… more
- Elevance Health (Waukesha, WI)
- ** Medicare Risk Adjustment Advanced...creating a culture that is designed to advance our strategy but will also lead to personal and professional ... an accommodation is granted as required by law._ The ** Medicare Risk Adjustment Advanced Analytics...of our culture. They are how we achieve our strategy , power our business outcomes and drive our shared… more
- Marshfield Clinic (Marshfield, WI)
- … Risk Adjustment Revenue Director is a finance leader responsible for risk adjustment strategy and related revenue management for Sanford Health ... Plan's Medicare , Affordable Care Act and Medicaid business and reports...as Sanford Health Services executives and leadership to lead risk adjustment strategy and process.… more
- Datavant (Madison, WI)
- …to realize our bold vision for healthcare. **Role Overview** As a Product Manager, Risk Adjustment Analytics Products, you will contribute to the strategy ... and execution of analytics capabilities that power Datavant's risk adjustment solutions. You'll drive the development of robust, scalable, and actionable… more
- Molina Healthcare (Madison, WI)
- …well as automated analytical as well as Reporting modules related to Risk Adjustment for Medicaid, Marketplace and Medicare /MMP. + Assist Risk ... **Job Description** **Job Summary** The Analyst, Risk Adjustment -Predictive Analytics role will support Molina's Risk Adjustment Predictive Analytics… more
- Molina Healthcare (Madison, WI)
- …Azure, AWS, or Hadoop + 3-5 years of experience in Analysis related to HEDIS and/or Risk Adjustment + 3-5 years of experience in working with complex data to ... Educates users on how to use reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare...users on how to use reports + Builds intervention strategy reporting for the Risk and Quality… more
- Molina Healthcare (Madison, WI)
- …+ Establishes strategy and operational direction for engaging providers on risk adjustment & quality improvement in collaboration with the Plan President, ... , and Network team. + Collaborates with Health Plan Network to drive value-based care strategy related to risk adjustment & quality. + Sets Health Plan… more
- Humana (Madison, WI)
- …+ A strong understanding of clinical metrics and data (eg Quality measures, Risk Adjustment ratings, chronic condition management, PCP visit rates and ... VP, Health Services relies on medical background to create and oversee clinical strategy for the region. The Regional VP, Health Services requires an in-depth… more
- Datavant (Madison, WI)
- …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
- Humana (Madison, WI)
- …analyze large data sets + Knowledge of healthcare compliance, mainly primary care and risk adjustment , pharmacy knowledge a plus + Certified Coder (CPC, CRC, ... to assess, investigate, audit and validate the mitigation of compliance risk across the organization. This team ensures that healthcare providers align… more