- Hartford HealthCare (Farmington, CT)
- …observed to expected ratio (O:E), capture of appropriate severity of illness (SOI) and risk of mortality (ROM), risk adjustment and hierarchal condition ... capture (HCC) codes, risk adjustment , and other high quality documentation outcome measures. . Management of CDI standard work, workflows, policies, and… more
- New York State Civil Service (Brooklyn, NY)
- …NY Zip Code 11233 Duties Description NYCCC is recruiting a Director of Clinical Risk Management Department to oversee their Risk Management Department and will ... Center database.* Attending facility-wide committee meetings as a representative of the Risk Management Department* Serving as the Co-Chairperson of Risk … more
- Mount Sinai Health System (New York, NY)
- …for driving key population health goals including access, quality, utilization and accurate risk adjustment with a group of practices and (2) close partnership ... with the CDQI Director to drive accurate risk adjustment throughout the system. This Medical...all populations served, especially our patients covered under a Medicare arrangement (MSSP or MA). The MD will report… more
- New York State Civil Service (Brooklyn, NY)
- …treatment teams to mitigate potential for infectious disease.* Developing infection control risk assessment and plan along with educational programs for staff and ... Hiring Rate ($10,852), Geographic Pay Differential ($35,000), and Downstate adjustment of $4,000. The posted job rate is the...on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …providing needed data and reporting, and partner with actuaries to resolve related risk adjustment issues. The ideal candidate will have experience with ... Encounter Data, Medicare Advantage, Medicaid, ACA commercial, and clinical coding, possess...BI, and will have experience partnering with actuaries on risk adjustment issues. Your Responsibilities * Performs… 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 or … more
- UCLA Health (Los Angeles, CA)
- …and Prescription Drug (Part D) programs. In this vital role, you will conduct Risk Adjustment Data Validation (RADV) audits, compliance risk -based audits, ... and more. * Design and improve audit toolkits based on Medicare Advantage and Part D risk areas. * Collaborate with stakeholders and leadership to identify and… more
- Point32Health (NH)
- …and will work in a matrix environment collaborating with functions including risk adjustment , population health, finance, operations, actuarial, and sales. **Job ... and products. The Director will lead a team who negotiates contracts including risk arrangements to enable high performing provider networks that support goals for… more
- New York State Civil Service (Staten Island, NY)
- …treatment planning.* Participating in multidisciplinary case discussions, high- risk reviews, and administrative meetings.* Maintaining clinical documentation ... will be required.This position is eligible for a Downstate adjustment of $4,000.NOTE: 1. In order to be eligible...on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal… more
- New York State Civil Service (Queens Village, NY)
- …Provide direct mental health counseling and psychotherapeutic treatment* Conduct risk assessments, clinical evaluations, and intake screenings* Document and maintain ... will be required.This position is eligible for a Downstate Adjustment of $4,000.Notes:1. If you fail to maintain your...on any of the Federal and/or State Medicaid and Medicare exclusion lists (or excluded from any other Federal… more