- Datavant (Providence, RI)
- …life experiences to realize our bold vision for healthcare. **Role Overview** As a Product Manager , Risk Adjustment Coding Data Integration, you will own the ... data strategy and execution for Datavant's Retrospective Risk Adjustment Coding products, driving client data...and management of client data for MA, ACA, and Medicaid plans, ensuring HIPAA and CMS compliance + **Standard… more
- Molina Healthcare (Milwaukee, WI)
- …of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), ... **JOB DESCRIPTION** **Job Summary** The Manager , Medical Economics provides support and consultation to...performance is achieving desired results + Keep abreast of Medicaid and Medicare reforms and their impact on Molina… more
- Healthfirst (NY)
- …from an accredited institution. + At least 5 years previous work experience within risk adjustment + Credentialed Associate of the Society of Actuaries (ASA) + ... our provider community. + Keep abreast of New York Medicaid and Medicare reforms and their impact on the...Product and Actuarial analytical requests. + Experience with CMS/HHS risk adjustment payment methodologies. + Self-motivated, creative… more
- CVS Health (Hartford, CT)
- …of Disease (ICD) codes required. Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories ... ** Manager , Quality (IC)** to support our growing risk adjustment efforts. Manages operations pertaining to...vendors consistent with regulations by Centers for Medicare and Medicaid Services (CMS), Health and Human Services (HHS) for… more
- Datavant (Indianapolis, IN)
- …inpatient setting. + Current CCS, CRC, or CPC required. + Previous Medicare Advantage Risk Adjustment , CDI, Medicaid , Commercial RA, and HEDIS experience. + ... vision for healthcare. As a Sr. Client Coding Project Manager , you will plan, forecast, and manage client-facing coding...clients understand the shifts and trends happening in the risk adjustment coding space. **What you will… more
- Deloitte (Boise, ID)
- …product strategy + Reimbursement models - including value-based care/ACO modeling + Risk adjustment mechanisms + Group insurance products including disability, ... Health Actuary Consulting Manager Human Capital Our Human Capital practice is...including individual medical and small group markets and/or state Medicaid programs The wage range for this role takes… more
- MedKoder (Mandeville, LA)
- …company offers services including inpatient and outpatient facility coding, medical risk adjustment management, DRG coding management, coding education, clinical ... the direction of the Director of Physician Coding, the Audit and Education Manager is responsible for leading and maintaining the Auditing and Education team. This… more
- Henry Ford Health System (Troy, MI)
- …value-based reimbursement models and initiatives. Reporting to the Director, Risk Adjustment and Value-Based Payment, the Program Manager is responsible for ... The Program Manager - Population Health & Value-Based Payment has an...departmental staff and multi-disciplinary teams. + Knowledge of Medicare, Medicaid , Blue Cross and other third-party payers billing and… more
- CareOregon (Portland, OR)
- …and forecasting activities, actuarial analyses, accounting operations, financial reporting, risk adjustment and procurement functions. + Supports emerging ... accounting, financial reporting, financial planning, forecasting, actuarial analysis and risk adjustment + Expert understanding of financial structures,… more
- MedKoder (Mandeville, LA)
- …company offers services including inpatient and outpatient facility coding, medical risk adjustment management, DRG coding management, coding education, clinical ... management, diagnostics, surgeries, and procedures in compliance with applicable Medicare, Medicaid , and third-party payer guidelines to ensure receipt of accurate… more