- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …characteristic. Blue Cross and Blue Shield of Minnesota Position Title: Quality & Risk Adjustment Provider Consultant Location: Hybrid | Eagan, Minnesota Career ... * Knowledge of Health Care Quality measures * Certified Risk Adjustment Coder (CRC via AAPC) or...Manager (CHQM) * Registered Nurse * Solid knowledge of Medicare Advantage Business Compensation and Benefits: Pay… more
- CVS Health (Hartford, CT)
- …with a focus on forecast accuracy, key value realization across Stars, Risk Adjustment , provider/value-based care (VBC) economics, and investment evaluation. ... progressive Healthcare experience, including strategy/finance/actuarial with demonstrated focus on Medicare Advantage + Executive-ready communication skills; able… more
- Hartford HealthCare (Hartford, CT)
- …in a variety of settings 3. Identify process improvements to capture data for Medicare Risk Adjustment 4. Builds relationships, programs, and processes ... recognition programs and other common practices across the system. *JOB SUMMARY:* The Risk Adjustment Coder Educator develops and implements an enterprise-wide … more
- Amazon (San Francisco, CA)
- …will responsible primarily for several critical workstreams which include analysis of Medicare Advantage and Accountable Care Organization data, design and ... TME performance compared to plan expectations. Key job responsibilities -Analysis of Medicare Advantage and Accountable Care Organization data primarily -Medical… more
- Health Care Service Corporation (Chicago, IL)
- …key performance indicators, trends, and financial acumen + Knowledge of Medicare Stars, Medicare Risk Adjustment , and Medicare Finance. + Strong ... **Preferred Job Qualifications:** + Health insurance or healthcare industry experience supporting Medicare Advantage + Knowledge of Medicare Advantage… more
- New York State Civil Service (Monroe, NY)
- …Complete assessments, as needed, including capacity for informed consent, Risk Assessments, MOLST capacity, intelligence testing and measures of adaptive ... committees which include Human Rights Committee, Informed Consent Committee, and Local Risk Management Committee for approval. Participate as a member of the… more
- Deloitte (Colorado Springs, CO)
- …care and fee-for-service, Medicaid policy, budget forecasting and fiscal analyses, and risk adjustment + Support business development efforts for Federal and ... waivers (ie, 1115, 1915 b/c, 1332) + Experience with risk adjustment mechanisms + Experience with Provider...individual medical and small group markets + Experience with Medicare products, including Medicare Advantage … more
- Humana (Sacramento, CA)
- …interrelate across segments and/or enterprise-wide. **Regional VP of Health Services, Humana Medicare Advantage ** As the Regional VP of Health Services, you ... innovator, and relationship builder, ensuring alignment with Humana's mission and Medicare Advantage goals. **Primary Responsibilities:** Clinical Engagement &… more
- Point32Health (ME)
- …and will work in a matrix environment collaborating with functions including risk adjustment , population health, finance, operations, actuarial, and sales. **Job ... and experience working collaboratively with providers. + Preferred: 10-15 years of Medicare Advantage experience. Skill Requirements + Energetic, goal driven… more
- Johns Hopkins University (Baltimore, MD)
- …and operation of health insurance and managed care programs, including Medicaid and Medicare Advantage . + Deep understanding of the regulatory environment for ... such as claims processing, premium billing, encounter data, utilization management, risk adjustment , provider contracting, quality metrics, and related… more