- CareOregon (Portland, OR)
- … Analyst Department Finance Exemption Status Exempt Requisition # 24959 Direct Reports N/A Manager Title Risk Adjustment Analytics Manager Pay & ... reside in Oregon or SW Washington Job Summary The Risk Adjustment Analyst performs data extraction, conducts... initiatives and strategies for both the Medicare and Medicaid lines of business. This position provides recommendations regarding… more
- Trinity Health (Syracuse, NY)
- … adjustment payment models. . Identify coding discrepancies and work with risk adjustment auditor/ manager to communicate deficiencies to providers. Core ... Ability to conduct Education if needed. Auditing Experience Posting POSITION PURPOSE: The Risk Adjustment Coding Specialist works in a team environment and is… more
- CVS Health (Columbus, OH)
- …+ 2 to 5years Government Programs experience including Medicare, Commercial ACA, and/or Medicaid . + Risk adjustment working knowledge and understanding. + ... and target/actual dates of completion. + Support provider performance that improves risk score accuracy through meaningful engagement. + Manage project timelines and… more
- Marshfield Clinic (Marshfield, WI)
- …exciting missions in the world!** **Job Title:** Director of Actuarial and Risk Adjustment Services **Cost Center:** 682891378 SHP-Actuarial **Scheduled Weekly ... **Job Description:** **JOB SUMMARY** The Director of Actuarial & Risk Adjustment Services is a key leader...participation in any federally funded program, including Medicare and Medicaid . This is a condition of employment. Employee must… more
- Deloitte (Tempe, AZ)
- …with Medicaid waivers (ie, 1115, 1915 b/c, 1332) + Experience with risk adjustment mechanisms + Experience with Provider reimbursement streams (ie, DSH, UPL, ... health plan/insurance company experience + 5+ years of experience with Medicaid managed care capitation rate development and/or fee-for-service rate development +… more
- New York State Civil Service (Bronx, NY)
- NY HELP Yes Agency Mental Health, Office of Title Intensive Case Manager (NY HELPS), New York City Children's Center, Bronx Campus, P26040 Occupational Category ... Duties Description NYCCC is recruiting a Director of Clinical Risk Management Department to oversee their Risk ...- Statewide (NY HELPS) program as an Intensive Case Manager if they have:* Bachelor's degree in social work,… more
- Providence (Portland, OR)
- …Direct Commercial pricing, rate setting and rate filing, forecasting, budgeting, and estimating risk adjustment and risk transfer payment amounts. + ... **Description** **Senior Manager Actuarial Analytics \*Remote * Candidates residing in...Medicare Advantage Bid + Experience with Commercial, Medicare, and Medicaid revenue methodologies. + Demonstrated experience with managing professional… more
- Tufts Medicine (Lowell, MA)
- …aligned with the Hospital Quality and Equity Incentive Program of the Massachusetts Medicaid 1115 Waiver. This work will spread across the Tufts Medicine Health ... Medical Officer for Quality, the Melrose Wakefield Hospital Senior Director Quality, Risk Management & Patient Safety and the Lowell General Hospital Vice President,… more
- Marshfield Clinic (Marshfield, WI)
- …internal and external stakeholders as it relates to Medicare Advantage, ACA/Exchange and Medicaid risk adjustment reimbursement methodologies and policies to ... ensure the accuracy and integrity of risk adjustment data submitted to the Centers... data submitted to the Centers for Medicare & Medicaid Services (CMS) and the Department of Health Services… more
- Hartford HealthCare (Farmington, CT)
- …and education specialist will support documentation practices that comply with CMS risk adjustment program requirements and ICD 10 coding guidelines. Reporting ... to Manager of Audit and Education *_Position Responsibilities:_* *Key Areas...6. Identify process improvements to capture data for Medicare Risk Adjustment and help providers code to… more