- Datavant (Olympia, WA)
- …strategic recommendations to help clients understand the shifts and trends happening in the risk adjustment coding space. **What you will bring to the table:** + ... + Current CCS, CRC, or CPC required. + Previous Medicare Advantage Risk Adjustment , CDI, Medicaid, Commercial RA, and HEDIS experience. + Familiarity with HIPAA… more
- NASCO (Olympia, WA)
- …deployment of AI/ML (Machine Learning) and agentic models for payer analytics, risk adjustment , fraud detection, and personalized member engagement + ... deliver data-driven SaaS solutions that enhance healthcare payer operations, risk management, and member engagement. **Responsibilities** Governance + Manages… more
- Molina Healthcare (Everett, WA)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... evidence-based guidelines. + Experience in Utilization/Quality Program management + HMO/Managed care experience **PREFERRED LICENSE, CERTIFICATION, ASSOCIATION:** Board Certification (Primary Care preferred). **PHYSICAL DEMANDS:** Working environment is… more
- Molina Healthcare (Bellevue, 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
- CVS Health (Olympia, WA)
- …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
- Banner Health (WA)
- …years of Multi-Specialty - General Medicine (some HCC) Coding experience** with Certified Risk Adjustment Coder (CRC) certification in an active status, and have ... endless opportunities to grow in a career path at Banner Health! **This person supports charge capture for 6-10 providers in the General Medicine Multi-specialty service lines.** Production expectations generally are 9-14 charges per hour. In most of our… more
- Humana (Olympia, WA)
- …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 (Tacoma, WA)
- …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 (Olympia, WA)
- …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
- CenterWell (Olympia, WA)
- …or AHIMA coding certification. + A minimum of three years in primary care and risk adjustment coding. + A minimum of three assigning ICD-10 and outpatient ... procedure codes (CPT/HCPCS). + Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint). + Familiarity with coding software and platforms. + Strong grasp of ICD-10 and CPT coding guidelines. + Experience in medical record review and documentation… more