- ChenMed (Philadelphia, PA)
- …and mission-driven, primary care organization, is currently one of the most successful full-risk Medicare Advantage providers in the nation and has a vision to ... acts as a health coach, rather than just a consultant for sickness, by helping patients set short and...compliance with guidelines along with participating in risk and quality management programs, clinical meetings and other meetings as… more
- Highmark Health (Buffalo, NY)
- …the Organization are met or exceeded. Further, in a matrix management environment, the Medicare Advantage Quality Consultant is responsible for ... STARS, Medicaid HEDIS and risk revenue programs and clinical evidence-based guidelines.The Medicare Advantage Quality Consultant is expected to assess… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- … Quality and Manager (CHQM) * Registered Nurse * Solid knowledge of Medicare Advantage Business Compensation and Benefits: Pay Range: $88,600.00 - $117,400.00 ... Blue Cross and Blue Shield of Minnesota Position Title: Quality & Risk Adjustment Provider Consultant Location:...Position Title: Quality & Risk Adjustment Provider Consultant Location: Hybrid | Eagan, Minnesota Career Area: Customer… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …experience will be considered. * Experience in medical coding with a focus on Medicare Advantage and ACA risk adjustment. * Certified Risk Adjustment Coder (CRC) ... The Impact You Will Have As a Risk Adjustment Quality Assurance (QA) Consultant at BCBSMN, you'll...certification * In-depth knowledge of ACA & Medicare Advantage risk adjustment methodology, coding guidelines… more
- Health Care Service Corporation (Chicago, IL)
- …CMS regulatory requirements, including Medicare Marketing Guidelines + Experience with Medicare products (including Medicare Advantage , Medicare ... and healthcare systems in order to support and improve financial and quality performance within the contracted working relationship with the health plan. The… more
- Sedgwick (San Juan, PR)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Litigated Claims Consultant | Public Entity | Remote **Are you looking for an impactful job ... global company known for its excellence and customer service. + Take advantage of a variety of professional development opportunities that help you perform… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …data analysis. This roleleveragesdeepexpertiseinRiskAdjustment and healthcare data-primarily Medicare Advantage , Medicaid, and ACA Commercial-identifyingtrends ... have experience inRiskAdjustment methodologies, clinical coding, and healthcare programs ( Medicare Advantage , Medicaid, ACA Commercial), as well asproficiencyin… more
- CenterWell (Morrow, GA)
- …of three to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice coding and documentation in value… more
- CenterWell (Anderson, SC)
- …of three to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice coding and documentation in… more
- CenterWell (Phoenix, AZ)
- …of three to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice coding and documentation in value… more
