- 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
- Elevance Health (Norfolk, VA)
- …hospital medical records to ensure proper ICD-9 coding and compliance with risk adjustment requirements. **Location:** Virtual: This role enables associates to ... project and RADV. + Assists with National and Targeted Risk Adjustment Data Validation audits. + Participates...Coders or Practice Management Institute). + Experience working with Medicare Advantage and Medicaid preferred. + Experience… more
- New York State Civil Service (Newburgh, NY)
- …develop, train, and monitor implementation of behavioral assessments, behavior and high- risk behavior support plans, and medication monitoring plans for individuals ... includes the sum of statutory hiring rate for PS&T Grade 23 ($86,681) and Mid-Hudson adjustment ($2,000). The Mid-Hudson adjustment is also added to the job rate… more
- New York State Civil Service (NY)
- …treatment and expert testimony. * Specialized assessment (functional, personality, risk , competency, vocational, education) * Design and application of behavioral ... hiring rate ($25,077), Geographic Pay Differential ($20,000), and Downstate adjustment ($4,000). The Geographic Pay Differential and Downstate adjustment… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …tools or analytics platforms preferred. + Familiarity with RFP tracking systems, Medicare Advantage , or value-based care models is highly desirable. Knowledge, ... solutions that span the entire member lifecycle--from enrollment and billing to risk adjustment , Stars performance, and member engagement. Pareto's deep… more
- ChenMed (Miami, FL)
- …information. Calculates statistical and probability forecasts and models from data. + Runs CMS risk adjustment model to calculate member level risk scores. + ... finance preferred + Minimumfive(5) years of related experience + Experience in Medicare Advantage preferred **PAY RANGE:** $108,313 - $154,733 Salary **EMPLOYEE… more
- Sutter Health (Sacramento, CA)
- …contracts, ensuring accurate setup in collaboration with Operations and MCF.** + **Validate CMS Medicare Advantage and ACA risk scores, along with payer ... finance foundation and solid understanding of provider reimbursement principles-such as risk adjustment , capitation, and fee-for-service-who can apply this… more
- Point32Health (Canton, MA)
- …for key initiatives + Serve as the key liaison for Actuarial, Finance, Risk Adjustment , Corporate Data and Analytics, Medical Cost Management, and Pharmacy ... or related field **Experience** + Required (minimum): 5 years in Medicare Advantage , Medicaid managed care, or healthcare product strategy. + Preferred: 5… more