- WMCHealth (Valhalla, NY)
- …Applicant link Job Details: Job Summary: Serves as an internal expert on Risk Adjustment and Hierarchical Conditions Categories (HCC) coding. Specific duties ... setting with one or more of the following credentials: Certified Risk Coder (CRC), Certified Professional Coder certification (CPC), Certified Professional Medical… more
- Humana (Albany, NY)
- …with corporate and market teams, including IT, Quality Operations and Compliance, and Risk Adjustment , as well as vended partners. The Senior Data ... Quality/Integrity Engineer is accountable for engaging in and supporting all aspects of the HEDIS program and regulatory operations, including: vendor oversight, process development, system and technical configurations, and management of efforts to maximize… more
- Datavant (Albany, NY)
- …+ Familiarity with healthcare data, with bonus points for experience in the payer risk adjustment space + Deep comfort working with engineering and analytics ... teams to solve ambiguous and complex data challenges + A systems mindset: you enjoy untangling complexity and designing structures that scale + Skilled at taking complex topics and communicating them clearly to both technical and non-technical audiences +… more
- CVS Health (Albany, NY)
- …etc. + Knowledge of Medicare Advantage, chronic condition assessments, or risk adjustment documentation workflows + Proficiency in workforce analytics ... tools (eg, dashboards, route optimization, performance metrics) + Bilingual preferred (especially Spanish or other commonly spoken regional languages) **Why Join Us** This is a mission-critical role in a rapidly growing healthcare service model. You'll help… more
- Humana (Albany, NY)
- …experience in Medicare Advantage or Value-Based Care + AAPC CRC (Certified Risk Adjustment ) Certification + AAPC CDEO (Certified Documentation Expert Outpatient) ... Certification **Additional Information** As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable… more
- Molina Healthcare (Buffalo, NY)
- …directly with **clinicians, nurses, or case management teams** + Familiarity with risk adjustment , value-based care models, or healthcare performance metrics + ... Understanding of regulatory and compliance considerations (eg, HIPAA) in data handling To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing. Molina Healthcare offers a competitive… more
- CenterWell (Albany, NY)
- …specific to cardiology, nephrology, orthopedics, and oncology + Familiarity with risk adjustment methodologies and population health analytics. + Experience ... supporting provider contracting and negotiations. **Additional Information** + 100% remote role + Standard working hours required; 8:00 am - 5:00 pm; Central or Eastern Time Zones + <20% Annual travel to various Centerwell and Conviva markets **Work at Home… more
- St. Mary's Healthcare (Amsterdam, NY)
- …the Compliance and Privacy Officer. . Oversees insurance, auditing reviews (ie, HEDIS and / Risk Adjustment ), to ensure staff is completing requests in a timely ... manner. . Provides on-going EMR education to providers and staff. Serves as technical expert in health record content and documentation requirements. Utilizes several databases, electronic forms management systems and software to perform required tasks. .… more
- Molina Healthcare (Syracuse, NY)
- …applications -_** **which underpin essential business functions such as HEDIS reporting, Risk Adjustment (RA), and Health Plan Reporting.** + **_Azure ... Databricks._** + **_Python._** + **_Spark._** + **_QNXT._** **Preferred License, Certification, Association** Microsoft Technology, Mobility, ITIL To all current Molina employees: If you are interested in applying for this position, please apply through the… more
- Evolent (Albany, NY)
- …decision support systems is preferred + **Background in value-based care** models, risk adjustment , and quality measurement programs is preferred + **Experience ... with healthcare analytics** and population health management platforms is preferred **Healthcare Domain Knowledge That Matters** + Deep understanding of clinical workflows, value-based care models, and healthcare economics + Knowledge of healthcare regulatory… more