- Ankura (New York, NY)
- …investigations, and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment . The Senior Director will also support ... master's degree from an accredited college/university + 8+ years of experience in Medicare Risk Adjustment operations, internal audit, or compliance either… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …legally protected characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Director Risk Adjustment and Quality Analytics - Actuarial ... Impact You Will Have We are looking for a Director of Risk Adjustment and...bid development and financial forecasting. * Tracks and evaluates risk adjustment initiatives performance across Medicare… more
- Point32Health (Canton, MA)
- …with our corporate and business division goals. This position will report to the Director of Risk Adjustment Strategy, Operations and Quality Assurance. ... will oversee all provider engagement and reporting activities for risk adjustment programs and initiatives that impact Medicare , Medicaid, and Duals product… more
- CVS Health (Hartford, CT)
- …utilization management, and site-of-care optimization programs. * Coordinate with Stars, Risk Adjustment , and Network teams to capture cross-functional impacts ... it all with heart, each and every day. Executive Director , Medicare Part D Strategy leader will...strategy, forecasting, and sensitivity analyses, ensuring alignment with enterprise risk and margin targets. * Partner with PBM, Clinical,… more
- Catholic Health Initiatives (Little Rock, AR)
- …for the value hub. + Through Risk Management/Auditor Manager, implements a risk adjustment coding department in appropriate Arkansas and Kentucky CIN. + ... Extensive CIN/Population Health Management experience required + Must have experience with risk adjustment coding and value based reimbursement models of payment… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …for the execution and day-to-day management of data submissions for ACA Commercial, Medicare , and Medicaid risk adjustment and quality programs. * ... team responsible for maintaining, executing, and evaluating initiative impacts using the risk adjustment and quality analytics models across ACA Commercial, … more
- Mount Sinai Health System (New York, NY)
- …adjustment with a group of practices and (2) close partnership with the CDQI Director to drive accurate risk adjustment throughout the system. This ... hardwiring processes to drive excellence in efficiency of care, quality and accurate risk adjustment for all populations served, especially our patients covered… more
- ChenMed (Miami, FL)
- …+ Comprehensive knowledge of Medicare program including but not limited to Risk Adjustment processes and Fee For Service. + Knowledge of applicable federal, ... need great people to join our team. The Associate Director , Revenue Cycle Management (RCM) Optimization manages and organizes...incumbent also serves as a subject matter expert on risk - adjustment and medical economics to aid in… more
- Point32Health (NH)
- …and will work in a matrix environment collaborating with functions including risk adjustment , population health, finance, operations, actuarial, and sales. **Job ... we are at Point32Health (https://www.point32health.org/) . **Job Summary** The Director of Contracting is responsible for contract strategy, development,… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …identify risks and opportunities for improvement. * Collaborate with Pharmacy, Risk Adjustment , Network Management, Care Management, Member Experience, Medical ... alignment with regulatory requirements, financial objectives, and organizational strategy. The Director oversees programs such as Medicare Stars, HEDIS,… more