- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …transform healthcare? Bring your true colors to blue. Under the direction of the Senior Director of Medicare Risk Adjustment and Analytics, the Associate ... Director of Risk Adjustment Data and Analytics is responsible...scripting, macros) preferred + Demonstrated attention to detail, delivering quality results and operating collaboratively as part of a… more
- CareFirst (Baltimore, MD)
- … across the organization within Medicare Advantage, Medicaid & ACA markets. The Risk Adjustment Director is responsible for strategic direction, leadership, ... **Resp & Qualifications** **PURPOSE:** The Director , Risk Adjustment oversees...as an SME to guide CareFirst's VP of Enterprise Quality & Risk Adjustment , Finance,… more
- Corewell Health (Grand Rapids, MI)
- Job Summary The Director Risk Adjustment Prospective Operations & Risk Mitigation is the thought leader role responsible for ensuring the complete and ... quality and overall impact of the company's risk adjustment program, including reporting KPIs on...collaboration cross all relevant internal departments/positions that intersect with risk adjustment ( Quality , Provider Relations,… more
- Blue KC (Kansas City, MO)
- …with adoption financial assistance** **Employee discount program** **Job Description Summary:** The Director , Government Programs Risk Adjustment & Audit ... risk adjusted revenue optimization strategy and oversight of Government Programs Risk Adjustment programs. **Job Description** + Interface with Blue KC… more
- Datavant (Honolulu, HI)
- …strategic mindset and a focus on continuous improvement. + Familiarity with CMS HCC risk adjustment processes preferred \#LI-BC1 We are committed to building a ... experiences to realize our bold vision for healthcare. The Director of Client Success will report to the VP...updates, etc.). + Identify project risks that impact the quality of our product and services delivery to clients,… more
- Ankura (New York, NY)
- …college/university + Current Registered Nurse license + Experience working for payors conducting risk adjustment reviews + Clinical experience in a variety of ... and mature their compliance programs, conduct program effectiveness reviews, and risk assessments, and perform compliance audits. We assist in-house and outside… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …Medicare Risk Adjustment Strategy Program Manager will report to the Senior Director of Medicare Risk Adjustment and Analytics. This role will manage ... the process of developing and maintaining the risk adjustment strategic plan. This position will...to multi-task and manage multiple deliverables while demonstrating high quality of work and meeting agreed upon deadlines +… more
- Commonwealth Care Alliance (Boston, MA)
- … Director of Encounter Data Management within the Revenue Cycle Department, the Risk Adjustment Data Developer is responsible for the design, development, and ... of data systems and tools that support Commonwealth Care Alliance's (CCA) risk adjustment and Hierarchical Condition Category (HCC) revenue programs. This… more
- Wells Fargo (New York, NY)
- **Model Risk Management (MRM)** is responsible for the enterprise-wide oversight and risk management of models across all phases of the model lifecycle. This ... identification, development, validation, implementation, usage, performance monitoring, documentation, and risk reporting of models. The team plays a critical role… more
- Mount Sinai Health System (New York, NY)
- …CDQI, who will (1) be responsible for driving key population health goals including access, quality , utilization and accurate risk adjustment with a group of ... practices and (2) close partnership with the CDQI Director to drive accurate risk adjustment...hardwiring processes to drive excellence in efficiency of care, quality and accurate risk adjustment … more
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