- Hartford HealthCare (Farmington, CT)
- …documentation to disseminate audit requirements. 6. Identify process improvements to capture data for Medicare Risk Adjustment and help providers code to the ... and education specialist will support documentation practices that comply with CMS risk adjustment program requirements and ICD 10 coding guidelines. Reporting… more
- Humana (Tallahassee, FL)
- …+ Experience with public speaking and presentation skills with healthcare providers + Medicare Risk Adjustment knowledge **Additional Information** Work at ... 4 or more years of medical coding experience + Risk Adjustment knowledge + Familiar with coding...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- Molina Healthcare (Janesville, WI)
- …plan products to coordinate a medical plan of care and capture diagnoses for Medicare risk adjustment . The NP/PA will utilize advanced assessment skills ... examination. + Capture and document annual diagnoses accurately consistent with Medicare risk adjustment . + Conduct comprehensive annual medication reviews… more
- CenterWell (Baton Rouge, LA)
- …+ Ability to travel up to 20% **Preferred Qualifications** + Proven experience with Medicare Advantage risk adjustment functions. + Proven track record of ... entities within the Primary Care Organization. **Strategy:** + In partnership with AVP, Risk Adjustment and AVP, MRA Strategy, responsible for driving ongoing… more
- CareFirst (Baltimore, MD)
- …Risk Adjustment oversees the outcomes and operations of risk adjustment across the organization within Medicare Advantage, Medicaid & ACA markets. The ... Risk Adjustment Director is responsible for strategic direction, leadership, establishing...direction, leadership, establishing and maturing key function, overseeing enterprise risk adjustment while identifying areas of improvements… more
- Dignity Health (Bakersfield, CA)
- …ad hoc analysis to demonstrate insights and trends related to patient engagement, Medicare risk adjustment , STARS/HEDIS, Medical management, and program ... including payer data sources, including but not limited to; Medicaid, Traditional Medicare , Medicare Advantage, value based programs, among others. 3. Engaging… more
- Datavant (Providence, RI)
- …outpatient or inpatient setting. + Current CCS, CRC, or CPC required. + Previous Medicare Advantage Risk Adjustment , CDI, Medicaid, Commercial RA, and HEDIS ... up to date with current coding policies for ICD-10, Medicare Advantage, HHS (ACA), and other markets. + Provide...clients understand the shifts and trends happening in the risk adjustment coding space. **What you will… more
- Centene Corporation (Queens, NY)
- …+ Develop and refine Medicare contract models to incorporate RAF ( Risk Adjustment Factor) trends, Stars quality metrics, and benchmarking methodologies to ... execution of the organization's Value-Based Payment strategies (VBP) and other risk -based contracting strategies. + Oversee Medicare -specific VBP contracts,… more
- Trinity Health (Syracuse, NY)
- …to conduct Education if needed. Auditing Experience Posting **POSITION PURPOSE:** A Risk Adjustment Auditor Educator is responsible for ensuring accurate coding ... and documentation in alignment with risk adjustment models, conducting audits with analysis...specialist with a solid background in value-based plans (VBP), Medicare Advantage (MA) and Medicare shared savings… more
- Molina Healthcare (Roswell, NM)
- …role will be responsible for work around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research, analysis and modeling ... complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data to evaluate healthcare...risk models including the various CMS models for Medicare Advantage members, the HHS model for Commercial ACA… more