- Molina Healthcare (Yonkers, NY)
- …The **Program Manager - Provider Engagement** plays a key role in driving risk adjustment and quality performance outcomes through effective program management, ... Development** + Develop, review, and update Standard Operating Procedures (SOPs) for risk adjustment and quality program workflows. + Maintain accurate,… more
- CDPHP (Latham, NY)
- …who share these values and invites you to be a part of that experience. The Risk Adjustment Coding Specialist will be responsible for the chart review and ICD-10 ... diagnosis coding of risk adjustment eligible members. This position will have responsibility for review of medical records to identify accurate ICD-10 diagnosis… more
- Molina Healthcare (Yonkers, NY)
- …monitoring, and oversight of all chart collection for HEDIS, or HEDIS-like projects, Risk Adjustment , Risk Adjustment Data Validation, and ... measures that support business objectives. + HEDIS Operations experience. + Risk Adjustment and Data Validation experience. + Chart Collection audit experience.… more
- Molina Healthcare (NY)
- …**Job Summary** This Sr. Analyst, Healthcare Analytics role will support Molina's Risk Adjustment Analytics team. The job responsibilities include developing ... developing queries within project management tools like Azure DevOps. + Risk Adjustment experience and some familiarity with Power BI level report building,… more
- Highmark Health (Albany, NY)
- …for efficiencies. May provide guidance to Associate level employees. **This role sits within our Risk Adjustment team - it is a remote based role - looking for ... who has some claims experience and looking to become familiar with risk adjustment .** **ESSENTIAL RESPONSIBILITIES** + Intake operational objectives and gather… more
- Datavant (Albany, NY)
- …and life experiences to realize our bold vision for healthcare. As an Auditor, HCC Risk Adjustment Coder, you will review medical records to identify and code ... using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical… more
- Datavant (Albany, NY)
- …Coding Supervisor serves as a working supervisor with oversight and management of Risk Adjustment team members. This includes monitoring production and quality ... of employees' work, process improvements and clear communication of expectations. This position supports and coaches front line talent to ensure the highest level of service to clients and ultimately the patient lives we impact. **You will:** + Supervise… more
- Datavant (Albany, NY)
- …using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical ... role in translating clinical documentation into precise codes that reflect the complexity and severity of a patient's health status. **You will:** + Review, analyze, and code diagnostic information in a patient's medical record based on client specific… more
- Datavant (Albany, NY)
- …strategic mindset and a focus on continuous improvement. + Familiarity with CMS HCC risk adjustment processes preferred \#LI-BC1 We are committed to building a ... diverse team of Datavanters who are all responsible for stewarding a high-performance culture in which all Datavanters belong and thrive. We are proud to be an Equal Employment Opportunity employer and all qualified applicants will receive consideration for… more
- Molina Healthcare (Albany, NY)
- …SKILLS & ABILITIES:** * 2+ years of program and/or project management experience in risk adjustment and/or quality * 2+ years of experience supporting HEDIS ... engine activity, risk adjustment targeting and reporting systems * 2+ years of data analysis experience utilizing technical skillsets and resources to answer… more
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