- CenterWell (Columbia, SC)
- …(clinical, financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and clinical ... improvement and coaching initiatives are precise + Identify critical issues for high- risk patients during case reviews & other forums, and model and drive… more
- Virginia Mason Franciscan Health (Silverdale, WA)
- …the Masters Social Worker include: crisis intervention, patient/family intervention, high- risk screening, brief counseling, referrals for financial or other ... discharges and engagement of appropriate agencies or community resources when high- risk patients are identified. **Essential Key Job Responsibilities** 1. Providing… more
- Sutter Health (Sacramento, CA)
- …finance foundation and solid understanding of provider reimbursement principles-such as risk adjustment , capitation, and fee-for-service-who can apply this ... setup in collaboration with Operations and MCF.** + **Validate CMS Medicare Advantage and ACA risk scores, along with payer codes, for accuracy, consistency, and… more
- Virginia Mason Franciscan Health (Burien, WA)
- …the Masters Social Worker include: crisis intervention, patient/family intervention, high- risk screening, brief counseling, referrals for financial or other ... discharges and engagement of appropriate agencies or community resources when high- risk patients are identified. ESSENTIAL KEY JOB RESPONSIBILITIES 1. Providing… more
- Virginia Mason Franciscan Health (Tacoma, WA)
- …the Masters Social Worker include: crisis intervention, patient/family intervention, high- risk screening, brief counseling, referrals for financial or other ... and engagement of appropriate agencies or community resources when high- risk patients are identified. **Essential Job Functions:** + Providing developmentally… more
- Fallon Health (Worcester, MA)
- …preparation of actuarial components of financial reports, regulatory submissions, and risk adjustment analyses + Collaborate with cross-functional teams ... to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE (Program of All-Inclusive Care for the Elderly)-… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …solutions that span the entire member lifecycle--from enrollment and billing to risk adjustment , Stars performance, and member engagement. Pareto's deep ... and proactively develop effective and practical legal strategies and solutions to address risk + Create processes for and manage compliance with securities rules and… more
- Molina Healthcare (Des Moines, IA)
- …of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), ... to improve financial performance. * Advanced understanding of Medicaid and Medicare programs or other health care plans. * Advanced analytical work… more
- CVS Health (Tallahassee, FL)
- …treatment protocols for DSNP/MMP and other complex health populations to optimize risk adjustment , clinical quality, and care management. * Actively participate ... oversight of DSNP/MMP complex populations (Dual-Eligible Special Needs Plan / Medicare -Medicaid Plan) * Develop and lead clinical strategy and objectives for… more
- Humana (Little Rock, AR)
- …with corporate and market teams, including IT, Quality Operations and Compliance, and Risk Adjustment , as well as vended partners. The Senior HEDIS Operations ... efforts are leading to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities at large. … more