- Humana (Alachua, FL)
- …community and help us put health first** The Medical Record Retrieval Specialist ( Risk Adjustment Representative 3) Travels to provider offices within the region ... by Humana's Coding staff. The Medical Record Retrieval Representative ( Risk Adjustment Representative 3): + Travel up...+ This job is part of Humana's Driver safety program and therefore requires an individual to have a… 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
- Genesis Healthcare (PA)
- …topics driving outcomes including, but not limited to: financial performance, risk adjustment , utilization management, quality performance, clinical performance, ... outcomes, enhance care coordination, and drive success in the Medicare Shared Savings Program . We help long-term...drive success in the Medicare Shared Savings Program . We help long-term care providers deliver high quality,… more
- Emanate Health (Covina, CA)
- …MSO personnel on HCC and STAR measures related tasks. Responsible to ensure the IPA risk adjustment factor maintains or exceeds 1.0 and achieves or improves upon ... Experience Requirement :** Must have at least one year of experience in Medicare HCC program within IPA, HMO, or clinic setting. Two to five years of coding… more
- CenterWell (Fort Worth, TX)
- …(clinical, financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and clinical ... performance improvement and coaching initiatives are precise *Identify critical issues for high- risk patients during case reviews & other forums, and modeling and… more
- CenterWell (Hampton, VA)
- …(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 modeling and driving… more
- 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
- 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 ... in collaboration with Operations and MCF.** + **Validate CMS Medicare Advantage and ACA risk scores, along...pay is just one piece of the total rewards program offered by Sutter Health. Eligible roles also qualify… more
- Fallon Health (Worcester, MA)
- …preparation of actuarial components of financial reports, regulatory submissions, and risk adjustment analyses + Collaborate with cross-functional teams ... strive to be the leading provider of government-sponsored health insurance programs-including Medicare , Medicaid, and PACE ( Program of All-Inclusive Care for the… 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