- Corewell Health (Grand Rapids, MI)
- Job Summary The Director Risk Adjustment Prospective Operations & Risk Mitigation is the thought leader role responsible for ensuring the complete and ... role is a key strategic leader who initiates, develops and executes/implements the multi-product risk adjustment strategy set by the executive leaders of Risk… more
- Tufts Medicine (Burlington, MA)
- …the greater Boston region. **Job Overview** Under the director of the Director, Risk Adjustment Operations, performs accurate and timely reviews and validations ... of Medicare , Medicaid, Commercial HCCs and DxCG's through medical record...established coding standards as well as CMS and Commercial Risk Adjustment guidelines. This position has extensive… more
- Centene Corporation (Tallahassee, FL)
- … risk adjustment regulatory landscape preferred + Risk Adjustment regulatory audit experience preferred + Medicare experience preferred Pay Range: ... Purpose:** Manages a team responsible for supporting key elements of the Risk Adjustment Compliance program with a focus on the auditing and monitoring… more
- Trinity Health (Albany, NY)
- **Employment Type:** Full time **Shift:** Day Shift **Description:** Risk Adjustment Coding Specialist -St. Peter's Health Partners - Full-time - Remote ... **POSITION PURPOSE:** The Risk Adjustment Coding Specialist works in a...adhering to coding guidelines established by the Centers for Medicare and Medicaid Services (CMS). **SKILLS, KNOWLEDGE, EDUCATION AND… more
- Centene Corporation (Tallahassee, FL)
- … risk adjustment regulatory landscape preferred + Risk Adjustment regulatory audit experience preferred + Medicare experience preferred Pay Range: ... from home anywhere in the Continental United States.** **Position Purpose:** Supports the Risk Adjustment Compliance program elements, with a focus on the… more
- Datavant (Lincoln, NE)
- …to realize our bold vision for healthcare. **Role Overview** As a Product Manager, Risk Adjustment Analytics Products, you will contribute to the strategy and ... execution of analytics capabilities that power Datavant's risk adjustment solutions. You'll drive the development of robust, scalable, and actionable analytics… more
- Marshfield Clinic (Marshfield, WI)
- …exciting missions in the world!** **Job Title:** Director of Actuarial and Risk Adjustment Services **Cost Center:** 682891378 SHP-Actuarial **Scheduled Weekly ... **Job Description:** **JOB SUMMARY** The Director of Actuarial & Risk Adjustment Services is a key leader...excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment.… more
- Centene Corporation (Austin, TX)
- …department overseeing compliance with regulations and laws related to Risk Adjustment across our Marketplace, Medicaid and Medicare lines of business, which ... assessments oversight and the monitoring work plans pertaining to Risk Adjustment . Partners with business areas to ensure and implement effective prevention,… more
- Humana (Des Moines, IA)
- …a part of our caring community and help us put health first** The Risk Adjustment Representative 2 conducts quality assurance audits of medical records and ... Medicare and Medicaid Services (CMS) and other government agencies. The Risk Adjustment Representative 2 performs varied activities and moderately complex… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …delivery of high-quality, trustable clinical data to support key initiatives around quality, risk adjustment , medicare stars, and interoperability. This is a ... + Collaborate with cross-functional teams, including clinical operations, performance measurement, and risk adjustment , to execute on data procurement & usage… more