- Marshfield Clinic (Marshfield, WI)
- …to support the most exciting missions in the world!** **Job Title:** Risk Adjustment Revenue Director (Remote/Hybrid) **Cost Center:** 682891390 SHP-Strategic ... (United States of America) **Job Description:** **JOB SUMMARY** The Risk Adjustment Revenue Director is a finance...or be excluded from participation in any federally funded program , including Medicare and Medicaid. This is… more
- Corewell Health (Grand Rapids, MI)
- …achieving related revenue targets.The role is responsible for helping to achieve the risk adjustment program vision, strategies, objectives, and goals. This ... performance indicators (KPIs) measure productivity, quality and overall impact of the company's risk adjustment program , including reporting KPIs on a… more
- CareFirst (Baltimore, MD)
- …and manage tracking tools, dashboards, and metrics for monitoring the progress of the Risk Adjustment Program across all lines of business. Drives member ... oversees the outcomes and operations of risk adjustment across the organization within Medicare Advantage,...coding quality. + Successful completion of a Coding Certificate program from an accredited organization (ie, CPC, CRC, CPMA… 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)
- …remote from home anywhere in the Continental United States.** **Position Purpose:** Supports the Risk Adjustment Compliance program elements, with a focus on ... adjustment regulatory landscape preferred + Risk Adjustment regulatory audit experience preferred + Medicare ...additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that… 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 ... includes implementation of elements of an effective compliance program . Oversee the development of risk assessments...assessments oversight and the monitoring work plans pertaining to Risk Adjustment . Partners with business areas to… more
- Centene Corporation (Queens, NY)
- …+ Develop and refine Medicare contract models to incorporate RAF ( Risk Adjustment Factor) trends, Stars quality metrics, and benchmarking methodologies to ... execution of the organization's Value-Based Payment strategies (VBP) and other risk -based contracting strategies. + Oversee Medicare -specific VBP contracts,… more
- CVS Health (Boston, MA)
- …regulatory compliance. + Serve as a subject matter expert on CMS regulations, risk adjustment , and revenue optimization. + Collaborate with internal stakeholders ... CMS Part C/D operations. + 5+ years' experience working with CMS regulations, risk adjustment methodologies, and revenue management. + 5+ years' experience… more
- Hartford HealthCare (Hartford, CT)
- … to support documentation practices among contracted providers that comply with CMS risk adjustment program requirements and ICD 10 coding guidelines. ... settings 3. Identify process improvements to capture data for Medicare Risk Adjustment 4. Builds...starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters.… more
- Dignity Health (Bakersfield, CA)
- …and trends related to patient engagement, Medicare risk adjustment , STARS/HEDIS, Medical management, and program effectiveness. 8. Ability to communicate ... including payer data sources, including but not limited to; Medicaid, Traditional Medicare , Medicare Advantage, value based programs, among others. 3. Engaging… more
Recent Jobs
-
Sustainable Sourcing Associate
- Nestle (Solon, OH)
-
Attorney - Debt Capital Markets
- Bank of America (New York, NY)
-
Guarantee Services Representative
- GAF (Parsippany, NJ)
-
Analyst, Mortgage Capital Markets, Global Capital Markets
- Scotiabank (Houston, TX)