- CVS Health (Montgomery, AL)
- …and/or auditing. + Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories (HCC) required. + ... Completion of AAPC/AHIMA training program for core credential (CPC, CCS-P) with associated work...Experience with Medicare and/or Commercial and/or Medicaid Risk Adjustment process and Hierarchical Condition Categories… more
- St. Luke's University Health Network (Easton, 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
- WelbeHealth (Los Angeles, CA)
- …Python, R), Excel, and financial modeling tools + Deep understanding of CMS risk adjustment , Medicaid rate-setting, and Medicare Advantage/Part D payment ... and financial analysis. This role will focus on overseeing capitation rates, risk adjustment methodologies, claims forecasting, and Incurred But Not Reported… more
- New York State Civil Service (Bronx, NY)
- …NY Zip Code 10461 Duties Description NYCCC is recruiting a Director of Clinical Risk Management Department to oversee their Risk Management Department and will ... with senior administrators as needed.* Acting as a resource to team leaders/ program directors as well as CRMs, identifying reportable incidents and facilitating the… 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 ... patients.* Evaluating the effectiveness of the infection control program and revising as needed.* Leading annual flu prevention, treatment, and reporting.*… 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
- AdventHealth (Hinsdale, IL)
- …Paid Time Off from Day One for FT/PT positions Student Loan Repayment Program for FT/PT positions Career Development Whole Person Wellbeing Resources Mental Health ... 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-… more
- Humana (Little Rock, AR)
- …Business, Finance, Health Care/Administration, RN or a related field + Experience with Medicare Risk Adjustment and/or medical coding + Proven organizational ... advance their goals related to interoperability, quality, value-based arrangements, and risk adjustment strategies. Recommend execution strategies and monitor… more
- New York State Civil Service (Queens Village, NY)
- …Management Administrator 3 (HIMA 3) will oversee the health information management program for Bernard Fineson DDSOO (BFDDSO) and ensure that the department remains ... HIMA 3 will: manage the day-to-day operations of BFDDSO's medical records program ; plan, implement, and maintain systems for acquiring and preserving individuals'… more
- Henry Ford Health System (Troy, MI)
- …value-based reimbursement models and initiatives. Reporting to the Director, Risk Adjustment and Value-Based Payment, the Program Manager is responsible for ... The Program Manager- Population Health & Value-Based Payment has...both departmental staff and multi-disciplinary teams. + Knowledge of Medicare , Medicaid, Blue Cross and other third-party payers billing… more