- Molina Healthcare (ID)
- …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...(APC's), and other payment mechanisms. * Understanding of value-based risk arrangements + Experience in quantifying, measuring, and analyzing… more
- Amazon (Denver, CO)
- …them to completion. Amazon Web Services is looking for an Infrastructure Technical Program Manager to support and deploy one of the world's largest and most complex ... systems are required. Key Responsibilities Include: . Reports to the GCID-FD Deployment Manager , and updates regularly with Global Senior management. . Serve as a… more
- Deloitte (Los Angeles, CA)
- …reimbursement, MS-DRG, APR-DRG, PSIs, HACs, POA, Vizient, Elixhauser, public profiling, and risk adjustment + Has strong interpersonal skills to collaborate with ... Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk & Forensic team helps client leaders translate multifaceted risk … more
- University of Washington (Seattle, WA)
- … System (HCPCS) codes in Epic work queues (WQ) and/or Hierarchical Condition Category (HCC)/ Risk Adjustment Factor (RAF) and/or Care Gap review to ensure optimal ... Information Management department. Under the general supervision of the Manager of Facility Coding , and the direct supervision of the Supervisor of Outpatient… more
- Bristol Myers Squibb (Princeton, NJ)
- …resilience from a Business Continuity Management (BCM), Crisis Response, and proactive risk identification and mitigation perspective. This role will support the BCM ... and tools, including those that drive our BCM planning and proactive risk management capabilities. **Roles and Responsibilities:** + Drive partnership with business… more
- CenterWell (Tallahassee, FL)
- …more years of experience as a certified medical coder + Experience with Medicare Risk Adjustment coding **Additional Information** + Remote Role + Standard ... ICD-10-CM, CPT, and HCPCS standards. This position utilizes GenAI and advanced coding tools to perform efficient chart reviews, ensure compliance with regulatory… more
- East Boston Neighborhood Health Center (Revere, MA)
- …state PACE financial requirements, including budgeting, encounter reporting, capitation reconciliation, risk adjustment , and cost allocation. + Serve as internal ... PACE regulations, 340B program, and Medicaid/Medicare reimbursement + Third-party billing, risk adjustment , and alternative payment methodologies + Grants… more
- UCLA Health (Los Angeles, CA)
- …and Prescription Drug (Part D) programs. In this vital role, you will conduct Risk Adjustment Data Validation (RADV) audits, compliance risk -based audits, ... with CMS and DMHC regulations across the organization. Reporting to the Compliance Manager , MAPD Audit, you will contribute to the organization's audit work plan,… more
- Amazon (Seattle, WA)
- …8am-5pm. Specific team norms around working hours will be communicated by your manager . Interns should not have conflicts such as classes or other employment during ... time of job offer. Would you like to assess risk and help deliver countermeasures that protect customer data...in a real-world setting. Basic Qualifications - Experience with coding /scripting in one or more languages (eg, Python, C,… more
- Point32Health (RI)
- …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 ... Working under the direction of the Director or Senior Manager , the Senior Network Performance Analyst will be part...and Reserving to ensure open communication relating to provider risk deals. + In-depth knowledge and understanding of managed… more