- Molina Healthcare (Syracuse, NY)
- **JOB DESCRIPTION** **Job Summary** Responsible for Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and reporting. ... analyze impact. **KNOWLEDGE/SKILLS/ABILITIES** + Collaborate with Actuarial staff to calculate risk adjustment payment estimates. Document assumptions. + Analyze… more
- Molina Healthcare (Buffalo, NY)
- …**Job Summary** The Senior Analyst will serve a key role on the RADV ( Risk Adjustment Data Validation) team, contributing to the end-to-end data strategy and ... required for audit response. + Collaborate with internal stakeholders-including IT, Risk Adjustment operations, clinical teams, and retrieval vendors-to ensure… more
- Molina Healthcare (NY)
- …**Job Summary** The Junior Analyst will play a supporting role on the RADV ( Risk Adjustment Data Validation) team, assisting in the execution of CMS and ... and confirm required data elements. + Collaborate with internal teams-including IT, Risk Adjustment operations, and clinical teams-to ensure accurate and… 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
- Ankura (New York, NY)
- …college/university + Current Registered Nurse license + Experience working for payors conducting risk adjustment reviews + Clinical experience in a variety of ... and mature their compliance programs, conduct program effectiveness reviews, and risk assessments, and perform compliance audits. We assist in-house and outside… more
- Datavant (Albany, NY)
- …coded in 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 and confirming the accuracy of said work. **What You Will Do:** + Audit coded charts assigned by quality supervisor per the… 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
- Datavant (Albany, NY)
- …skills, and experience for a specific job. The estimated total cash compensation range for this role is: $27-$30 USD To ensure the safety of patients and staff, many ... of our clients require post-offer health screenings and proof and/or completion of various vaccinations such as the flu shot, Tdap, COVID-19, etc. Any requests to be exempted from these requirements will be reviewed by Datavant Human Resources and determined… 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