- 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
- Independent Health (Buffalo, NY)
- …on pricing outcomes. + Establish and implement claims review processes to support risk adjustment . Analyze data and provide strategic insights to enhance pricing ... and financial performance. + Ensure compliance with CMS regulations and risk adjustment methodologies. + Develop and execute pricing strategies, incorporating… more
- Healthfirst (NY)
- …from an accredited institution. + At least 5 years previous work experience within risk adjustment + Credentialed Associate of the Society of Actuaries (ASA) + ... supporting Product and Actuarial analytical requests. + Experience with CMS/HHS risk adjustment payment methodologies. + Self-motivated, creative problem solver… more
- Molina Healthcare (NY)
- …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 ... **Job Description** **Job Summary** The Sr Analyst, Risk and Quality Reporting role supports Molina's ... Risk and Quality Reporting role supports Molina's Risk and Quality Health Plan team. Designs and develops… more
- Molina Healthcare (Buffalo, NY)
- …+ Provides training and education to network of providers on how to improve their risk adjustment knowledge as well as provide coding updates related to Risk ... in related field **Preferred Experience** + Familiar with HCC (Hierarchical Condition Categories) Risk Adjustment Model + Background in supporting risk … more
- Datavant (Albany, NY)
- …The individual will provide superior quality by performing audits pertaining to risk adjustment coding efforts. The individual will be responsible for ... ensuring coding compliance and accuracy + Monitor the performance of the Risk Adjustment Operations both internally and with coding vendors + Provides expertise… more
- Mount Sinai Health System (New York, NY)
- …for driving key population health goals including access, quality, utilization and accurate risk adjustment with a group of practices and (2) close partnership ... with the CDQI Director to drive accurate risk adjustment throughout the system. This Medical Director must be effective at influencing physicians, medical… more
- Ankura (Lexington, NY)
- …assessment. + Apply innovative techniques to healthcare engagements including those related to Risk Adjustment . + Expand and build new products in a ... an Industry thought leader in healthcare topics like predictive analytic applications, risk adjustment , and value-based care. + Develop, supervise, and motivate… more
- CVS Health (Albany, NY)
- …the Centers for Medicare and Medicaid Services (CMS) for the purpose of risk adjustment processes are appropriate, accurate, and supported by clinical ... Disease (ICD) codes. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) preferred.… more
- Datavant (Albany, NY)
- …team coordinates efforts between internal resources and clients in support of custom risk adjustment projects and reports on project status to all stakeholders. ... technology or related field + Knowledge of healthcare industry, payment models, risk adjustment , medical coding, physician workflow, and/or electronic health… more