- 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 ... Documentation Integrity (CDI) by providing day-to-day oversight of the program . They also represent and support CDI at the...capture (HCC) codes, risk adjustment , and other high quality documentation outcome measures. .… 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
- Humana (Oklahoma City, OK)
- …and help us put health first** The Medical Records Retrieval Representative ( Risk Adjustment Representative 2) conducts quality assurance audits of medical ... Medicare and Medicaid Services (CMS) and other government agencies. The Risk Adjustment Representative 2 performs varied activities and moderately complex… 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 (Shawnee, KS)
- …Vision, Medical & Dental Benefits from Day One + Student Loan Repayment Program + Received Magnet recognition from the American Nurses Credentialing Center in ... 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
- 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 (Olympia, WA)
- …nursing (BSN), or a related field, or equivalent work experience. + Experience with Medicare Risk Adjustment and/or medical coding. + Experience with ... advance their goals related to interoperability, quality, value-based arrangements, and risk adjustment strategies. Recommend execution strategies and monitor… 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
- 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
- Point32Health (ME)
- …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