- Datavant (Olympia, WA)
- …ability to collaborate cross-functionally in a fast-paced environment. Experience in healthcare and risk adjustment is a plus. **What You Will Do:** + **Contract ... **What Helps You Stand Out:** + Background in healthcare, healthcare operations, or risk adjustment . + Experience partnering with Sales, Client Success, and Deal… more
- Molina Healthcare (Spokane, WA)
- …of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), ... (APC's), and other payment mechanisms. * Understanding of value-based risk arrangements * Experience in quantifying, measuring, and analyzing financial,… more
- Molina Healthcare (Spokane, WA)
- …of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), ... (APC's), and other payment mechanisms. * Understanding of value-based risk arrangements + Experience in quantifying, measuring, and analyzing financial,… more
- Molina Healthcare (WA)
- …of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), ... (APC's), and other payment mechanisms. * Advanced understanding of value-based risk arrangements * Advanced experience in quantifying, measuring, and analyzing… more
- Vatica Health (WA)
- …This unique combination of people, process, and technology unites Vatica's #1-rated risk adjustment platform with Cozeva's #1-rated quality and population health ... customers and guide them through a seamless onboarding process, reducing churn risk and establishing a foundation for a long-term partnership. The Enterprise… more
- Molina Healthcare (Bellevue, WA)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... evidence-based guidelines. 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 benefits and compensation package. Molina Healthcare is an… more
- Providence (WA)
- …the rate development and filing efforts including competitive analysis, network analysis, risk adjustment , trend, actuarial value analysis, rate adequacy review, ... etc. Providence Health Plan caregivers are not simply valued - they're invaluable. Join our team at Providence Health Plan Partners and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your… more
- Humana (Olympia, WA)
- …with corporate and market teams, including IT, Quality Operations and Compliance, and Risk Adjustment , as well as vended partners. The Senior HEDIS Operations ... & Quality Professional supports all aspects of the non-standard supplemental (NSS) program; including: systems readiness, process improvements, resource deployment, technology implementation, and data management/reporting. The Senior HEDIS Operations & Quality… more
- University of Washington (Seattle, WA)
- …System (HCPCS) codes in Epic work queues (WQ) and/or Hierarchical Condition Category (HCC)/ Risk Adjustment Factor (RAF) and/or Care Gap review to ensure optimal ... reimbursement for facility and/or professional fee coding and billing for Clinic, Outpatient and related charges needing coding review in compliance with State and Federal guidelines. **PRIMARY JOB RESPONSIBILITIES** + Validates codes entered at the point of… more
- Humana (Olympia, WA)
- …Electronic Medical Records, and/or Electronic Notifications. + Familiarity with CMS Risk Adjustment and Quality Measure Reporting. + Experience in ... UAT (User Acceptance Testing) / PPV (Post Production Validation Testing) scenario creation and data gathering. + Progressive strategic and operational experience. + Strong performance orientation for delivering high quality technology products. + SAFe PO/PM… more