- Catholic Health Initiatives (Little Rock, AR)
- …for the value hub. + Through Risk Management/Auditor Manager, implements a risk adjustment coding department in appropriate Arkansas and Kentucky CIN. + ... Extensive CIN/Population Health Management experience required + Must have experience with risk adjustment coding and value based reimbursement models of payment… more
- UPMC (Pittsburgh, PA)
- …Plan has an exciting opportunity for a Physician Educator position in the HCC Risk Adjustment Department. This is a full-time position working Monday through ... and documentation in the medical record and the various risk adjustment models of payment. The Physician...Plan. A general understanding of Health care insurance and Medicare managed care is highly preferred for this position,… more
- Humana (Salt Lake City, UT)
- …improvement opportunities and give guidance around operational and clinical best practices in the risk adjustment methodology. This role reports to the Risk ... influence a provider to adopt best practices in the risk adjustment methodology. The successful candidate will...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- Bluestone Physician Services (Stillwater, MN)
- …thorough patient chart reviews to identify opportunities for providers to capture risk adjustment diagnostic codes accurately. The successful candidate will play ... reviews of patient charts to identify gaps in documentation and opportunities for risk adjustment coding improvement. + Collaborate with Bluestone providers and… more
- Blue KC (Kansas City, MO)
- …groups. + Analyze data and monitor provider metrics to identify risk adjustment , HEDIS or educational opportunities for the Medicare Advantage and Qualified ... programs focused on improving the quality of care for Medicare Advantage & Qualified Health Plan (ACA) Members. +...business. + Develop educational tools for network providers regarding risk adjustment and HEDIS documentation and coding… more
- Amazon (IL)
- …current on CPT, ICD-10-CM coding guidelines, AHA Coding Clinic Guidance and CMS Risk Adjustment guidance. Assign appropriate ICD-10-CM, CPT, and other relevant ... requests in a timely manner. Work collaboratively with the Medicare Risk Operations team to ensure positive...a Profee Coder in an office setting inclusive of risk adjustment coder experience required * 1+… more
- Molina Healthcare (Iowa City, IA)
- …Health Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities. Drives ... place and carried out to meet annual quality & risk adjustment performance goals.** **Job Duties** +...Healthcare. + 1 year of experience in Medicaid and/or Medicare managed care To all current Molina employees: If… more
- Amazon (Seattle, WA)
- …economics reporting and ad-hoc analysis relating to cost of care management - Medicare Risk score projections and premium estimation -Design and implement ... responsible primarily for several critical workstreams which include analysis of Medicare Advantage and Accountable Care Organization data, design and implement an… more
- Corewell Health (Grand Rapids, MI)
- We are seeking a highly analytical and detail-oriented Risk Adjustment Reporting Developer to support our organization's Medicare Advantage, ACO, ACA, and ... BIDs, Data Engineers, Data Scientists, and internal/external customers. Essential Functions + Risk Adjustment Analytics & Reporting + Develop and deliver… more
- ChenMed (Miami, FL)
- …+ Comprehensive knowledge of Medicare program including but not limited to Risk Adjustment processes and Fee For Service. + Knowledge of applicable federal, ... incumbent also serves as a subject matter expert on risk - adjustment and medical economics to aid in...business acumen and acuity + In depth knowledge of Medicare , Medicaid, and commercial billing rules and regulations, coding,… more