• 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 ... work in collaboration with the clinical documentation specialists (CDS), coding professionals, providers, nursing staff and other patient care...capture (HCC) codes, risk adjustment , and other high quality documentation outcome measures. .… more
    Hartford HealthCare (09/17/25)
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  • Medical Economics Manager

    AdventHealth (Maitland, FL)
    …in understanding professional and facility claims and managed care concepts such as risk adjustment , capitation, FFS, DRG, APG, APCs and other payment mechanisms ... methodology, data tools, modeling, managing revenue, and managing and mentoring of director reports. Must be able to complete extensive and complex financial,… more
    AdventHealth (08/19/25)
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  • CDI Physician Advisor

    Sutter Health (Santa Rosa, CA)
    …knowledge of coding rules and regulations, along with understanding of risk adjustment and quality reporting methodology to achieve organizational goals * ... level of care with supporting documentation of regulatory compliance and accurate coding . The Physician Advisor (PA) conducts clinical reviews on cases referred by… more
    Sutter Health (09/13/25)
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  • Strategy Analyst

    Datavant (Helena, MT)
    …and accountability for delivering results **Bonus Points If:** + You have experience in risk adjustment coding applications and technology \#LI-BC1 We are ... the Strategic Operations team and reports directly to the Director of Strategic Operations. As a trusted partner to...of Strategic Operations. As a trusted partner to the Risk Adjustment COO and broader leadership team,… more
    Datavant (08/14/25)
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  • Senior Network & Provider Analytics

    Point32Health (CT)
    …claims data, coding schemes (ICD-9/ICD-10, CPT/HCPCS, DRGs), and health status risk adjustment . In-depth health care reimbursement and managed care business ... . **Job Summary** Working under the direction of the Director or Senior Manager, the Senior Network Performance Analyst...and Reserving to ensure open communication relating to provider risk deals. + In-depth knowledge and understanding of managed… more
    Point32Health (10/10/25)
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  • Virtual Currency Data Governance Senior Analyst…

    New York State Civil Service (Albany, NY)
    …up data in coordination with the Virtual Currency Data Governance Director ;* Creates and maintains interactive Tableau dashboards for scalability, manageability, ... otherwise add value to the team;* Ensures consistency by adhering to software coding and style guides;* Provides training and support to dashboard users and ensures… more
    New York State Civil Service (10/08/25)
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  • PFS Financial Counselor

    Tidelands Health (Murrells Inlet, SC)
    …of department head and/or patient advocate review process appropriate rebill or adjustment necessary and contact patient to offer timely and effective resolution of ... in the patient payment portal. + **Report any repetitive issues to Assistant Director of PFS.** Remaining in communication with manager regarding high- risk … more
    Tidelands Health (09/02/25)
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