- BlueCross BlueShield of North Carolina (NC)
- …at least 9 years of relevant actuarial experience. **Bonus Points** + Experience in Medicare Advantage Risk Adjustment highly preferred **What You'll ... Get** + The opportunity to work at the cutting edge of health care delivery with a team that's deeply invested in the community. + Work-life balance, flexibility, and the autonomy to do great work. + Medical, dental, and vision coverage along with numerous… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- … Adjustment Coder (CRC) certification * In-depth knowledge of ACA & Medicare Advantage risk adjustment methodology, coding guidelines (ICD-10-CM), ... military experience will be considered. * Experience in medical coding with a focus on Medicare Advantage and ACA risk adjustment . * Certified Risk… more
- Redeemer Health Home Care & Hospice (Huntingdon Valley, PA)
- …CPC or CCS-P, and AAPC CRC certification. 2+ years coding, Medicare Risk Adjustment / Medicare Advantage and/or clinical. Plans experience. Familiarity ... and supporting clinical care plans to Risk Adjustment Data Validation (RADV) Timelines. Medicare and...Risk Adjustment Data Validation (RADV) Timelines. Medicare and Medicaid regulations and billing guidelines and AMA's… more
- Humana (Louisville, KY)
- …Qualifications** + Financial or actuarial background + Medicare Risk Adjustment Experience + Medicare Advantage or Healthcare Industry Experience + ... hybrid based on business discretion. The MRA Finance team supports Humana's Medicare Risk Adjustment business area. The Finance team develops revenue and… more
- Blue KC (Kansas City, MO)
- …forecasting of that data. **Job Description** + Maintains expert knowledge of Medicare Advantage & ACA Risk Adjustment models + Responsible for all ... of the role + Minimum 5 years' experience in Medicare Advantage & ACA Risk Adjustment submission experience **Blue Cross and Blue Shield of Kansas… more
- Humana (Springfield, IL)
- …our caring community and help us put health first** The Director, Quality and Risk Adjustment has regional oversight of the development and implementation of the ... to increase the plan quality. Has regional oversight of risk adjustment to ensure appropriate implementation of...5 years of experience in provider performance management within Medicare Advantage programs, including oversight of provider… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Manager plays a critical role in the development and execution of the corporate risk adjustment ... strategy. The role serves as a dedicated resource within the organization for Medicare Advantage , Medicaid and ACA markets, coordinating and leading the end to… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …right for you, we encourage you to apply! Job Description: Summary The Risk Adjustment Coding Coordinator is responsible for various aspects of decision-making ... ensure accuracy and completeness in diagnosis coding. This position is responsible for risk adjustment coding and quality assurance validation for the following… more
- CareFirst (Baltimore, MD)
- …risks or barriers to leadership to ensure that all risk adjustment activities fully comply with Medicare , Medicaid, ACA, and state-specific regulations. ... **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Operations Supervisor supports...supports the execution of the corporate coding strategy across Medicare Advantage , Medicaid, and ACA markets. This… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Risk Adjustment Business Operations Analyst assumes a pro-active approach in ensuring the accuracy and ... integrity of key risk adjustment performance metrics through coordination of...and problem resolution to meet business operational requirements for Medicare Advantage (MA), Affordable Care Act (ACA) &… more