- Apex Health Solutions (Houston, TX)
- …CPT coding and compliance with Risk Adjustment requirements. Key Responsibilities Follows CMS Risk Adjustment guidelines and has a complete understanding of their ... medical records to identify ICD-10-CM diagnoses, ensuring the documentation meets all CMS standard requirements for valid submission Codes all diagnoses and services… more
- Dartmouth Health (Lebanon, NH)
- …Laboratory services to DHMC and Clinics physician practices, Dartmouth Health system member hospitals, and independent practices and hospitals throughout NH and ... Canada or an accredited laboratory* within the last five years. * CMS CLIA certificate of registration, compliance, accreditation; OR JCI accreditation; OR… more
- University of Miami (Boca Raton, FL)
- …and collects funds. + Maintains appropriate records, files, and accurate documentation in the system of record. + Serves as a lead resource for lower level Patient ... Access Representatives. + Recommends new approaches to management for enhancing performance and productivity. + Adheres to...not limited to: OSHA, HIPAA, JC, AHCA, EMTALA, and CMS . AREA SPECIFIC ER + Must possess a good… more
- UNC Health Care (Morrisville, NC)
- …necessary information to senior Analytic team members, including Contract Management leadership when required. Analyzes financial, contractual, and operational ... sources of information to improve analysis efforts and identifying essential policy content . 3. Uses Business Objects, Strata and other UNC approved reporting tools… more
- NTT DATA North America (Boston, MA)
- …+ Reduction in **Medical Loss Ratio (MLR)** through analytics, care management optimization, and value-based care enablement + Lower **administrative cost per ... + Anticipate and proactively address emerging payer challenges, including ** CMS regulations, interoperability mandates, risk adjustment changes, and competitive… more
- Hartford HealthCare (Farmington, CT)
- …Provides enterprise oversight of regulatory quality and reporting requirements for CMS and Joint Commission and collaborates with organizational leadership and ... for integrity and performance opportunities and leads Improvement initiatives with system and regional clinical leadership. . Synthesizes data with clinical… more
- University of Miami (Miami, FL)
- …intelligence, automation, and connected data. The AVP oversees enterprise CRM, content management systems, marketing automation, SEO/SEM, asset management ... the enterprise marketing technology roadmap, aligning platforms such as CRM, CMS , AI, marketing automation, and optimization tools to institutional priorities. +… more
- Humana (Boise, ID)
- …but not limited to: + Reviewing pricing software vendor specifications. + Identifying system changes needed to accommodate CMS logic. + Assisting with ... Analyst will be an integral part of the Pricer Business and System Support team responsible for administering complex Medicare provider reimbursement methodologies.… more
- Guidehouse (Atlanta, GA)
- …**:** + Lead quantitative analysis and modeling of real-world data, including CMS , commercial claims, and clinical health data, to generate actionable insights for ... experience in health data science and epidemiology, including deep experience analyzing CMS or commercial claims data, clinical data, or other large health datasets… more
- Fallon Health (Milford, MA)
- …Health Risk Assessments, Service Plans, and Care Plans in the TruCare system (care management platform) according to Regulatory Requirements and Program ... is an integral part on an interdisciplinary team focused on care coordination, care management and improving access to and quality of care for Fallon members. The… more