- AdventHealth (Shawnee, KS)
- …coordinates and facilitates the development of a discharge plan of care for high- risk patient populations. This role will receive referrals for individuals from at- ... risk populations from interdisciplinary team members (including physicians, RN...substance use and addictive disorders + Provides patient/family education, adjustment -to-illness counseling, grief counseling and crisis intervention + Provides… more
- CVS Health (Raleigh, NC)
- …Programs experience including Medicare ,** **Commercial ACA, and/or Medicaid** + ** Risk adjustment working knowledge and understanding** + **Understanding of ... building and maintaining robust data pipelines that power reporting and analytics for risk adjustment and provider performance projects. You'll work closely with… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …identify risks and opportunities for improvement. * Collaborate with Pharmacy, Risk Adjustment , Network Management, Care Management, Member Experience, Medical ... leadership for all enterprise quality performance programs across the organization's Medicare , Medicaid, ACA, and Commercial lines of business. This position leads… 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), ... ability to convert observations into actions/interventions to improve financial performance. * Advanced understanding of Medicaid and Medicare programs or other… more
- Deloitte (Los Angeles, CA)
- …reimbursement, MS-DRG, APR-DRG, PSIs, HACs, POA, Vizient, Elixhauser, public profiling, and risk adjustment + Has strong interpersonal skills to collaborate with ... Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk & Forensic team helps client leaders translate multifaceted risk … more
- St. Luke's University Health Network (Stroudsburg, PA)
- …patient as healthy as possible in the outpatient setting, minimizing the risk of readmissions. . Issues applicable state/federal regulatory notices as applicable ... ie.) Important Message from Medicare (IMM), Medicare Outpatient Observation Notice (MOON),...(MOON), Bundle Payment Care Initiative (BPCI) notification. . Monitors risk assessment using available tools and implements discharge interventions… more
- St. Luke's University Health Network (Quakertown, PA)
- …patient as healthy as possible in the outpatient setting, minimizing the risk of readmissions. + Issues applicable state/federal regulatory notices as applicable ... ie.) Important Message from Medicare (IMM), Medicare Outpatient Observation Notice (MOON),...(MOON), Bundle Payment Care Initiative (BPCI) notification. + Monitors risk assessment using available tools and implements discharge interventions… more
- SSM Health (MO)
- …scoring. + Collaborates with others regardingclinical documentation improvement (CDI) and risk adjustment (mortality) findings. + Maintains knowledge of Centers ... the current health status of network patients against ever-changing risk adjusted models. Responsible for achieving improved documentation results...for Medicare and Medicaid Services (CMS) requirements related to clinical… more
- Humana (Gainesville, FL)
- …community and help us put health first** The Medical Record Retrieval Specialist ( Risk Adjustment Representative 3) Travels to provider offices within the region ... The records are reviewed by Humana's Coding staff. The Medical Record Retrieval Representative ( Risk Adjustment Representative 3): + Travel up to 60% of the time… 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