• Supv Clinical Documentation / HIM Clinical…

    Hartford HealthCare (Farmington, CT)
    …observed to expected ratio (O:E), capture of appropriate severity of illness (SOI) and risk of mortality (ROM), risk adjustment and hierarchal condition ... capture (HCC) codes, risk adjustment , and other high quality documentation outcome measures. ....Evaluation and 1:1 discussions under the direction of CDI Manager/ Director . . Provides CDI subject matter expert guidance to… more
    Hartford HealthCare (09/17/25)
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  • Social Work Case Manager

    AdventHealth (Hinsdale, IL)
    …coordinates and facilitates the development of a discharge plan of care for high- risk patient populations. This role will receive referrals for individuals from at- ... risk populations from interdisciplinary team members (including physicians, RN...substance use and addictive disorders o Provides patient/family education, adjustment -to-illness counseling, grief counseling and crisis intervention o Provides… more
    AdventHealth (11/06/25)
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  • Social Worker Case Manager-Relief

    AdventHealth (Shawnee, KS)
    …coordinates and facilitates the development of a discharge plan of care for high- risk patient populations. This role will receive referrals for individuals from at- ... risk populations from interdisciplinary team members (including physicians, RN...substance use and addictive disorders + Provides patient/family education, adjustment -to-illness counseling, grief counseling and crisis intervention + Provides… more
    AdventHealth (10/07/25)
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  • Regional Manager, Value-Based Programs - REMOTE

    Molina Healthcare (WA)
    …with national quality and risk adjustment VPs, Regional Directors of Quality/ Risk , Director of Value Based Programs, and local health plan resources. + ... revenue management, strategy, and compliance + Knowledge of value based programs, risk adjustment models, quality metrics such as HEDIS and STARS, knowledge… more
    Molina Healthcare (11/09/25)
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  • Inpatient Social Worker (MSW) or Registered Nurse…

    St. Luke's University Health Network (Stroudsburg, PA)
    …to: RN care managers, assistants, coordinators, utilization management staff, and director . . Facilitates communication among all treatment team members. . Manages ... patient as healthy as possible in the outpatient setting, minimizing the risk of readmissions. . Issues applicable state/federal regulatory notices as applicable… more
    St. Luke's University Health Network (11/03/25)
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  • Inpatient Registered Nurse or Social Worker (MSW)…

    St. Luke's University Health Network (Quakertown, PA)
    …to: RN care managers, assistants, coordinators, utilization management staff, and director . + Facilitates communication among all treatment team members. + Manages ... patient as healthy as possible in the outpatient setting, minimizing the risk of readmissions. + Issues applicable state/federal regulatory notices as applicable… more
    St. Luke's University Health Network (10/17/25)
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  • RN, Care Manager

    Whidbey General Hospital (Coupeville, WA)
    …in-hospital stay to discharge: When the patient and or family has specific adjustment or psych/social needs, the social worker is integrated into the care plan ... up may be indicated for patients who have been identified as high risk for re-hospitalization or non-compliance with recommended follow up care. + Facilitates… more
    Whidbey General Hospital (10/01/25)
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  • Experienced Care Manager Registered Nurse RN…

    AdventHealth (Orlando, FL)
    …under the general supervision of the Care Managment Supervisor or Manager or Director of Nursing and is responsible for patient evaluations of post-hospital needs; ... social determinants of health into transitions of care planning and applies risk mitigation interventions to meet the individual needs of each patient Identifies… more
    AdventHealth (11/11/25)
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  • HCC Coding Specialist - Exempt - Full Time - Days…

    Emanate Health (Covina, CA)
    …MSO personnel on HCC and STAR measures related tasks. Responsible to ensure the IPA risk adjustment factor maintains or exceeds 1.0 and achieves or improves upon ... ensure the appropriate ICD10 and CPT codes submitted for Medicare and Covered CA lines of business. Coding specialist...Must have at least one year of experience in Medicare HCC program within IPA, HMO, or clinic setting.… more
    Emanate Health (10/17/25)
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