• Psychologist 1/2 - Long Island - Suffolk County…

    New York State Civil Service (NY)
    …who was a witness to or victim of verbal or psychological abuse* Perform risk assessments and create risk management plans, as needed, for individuals. Present ... necessary documents to the Risk Management Advisory Committee, as needed* Perform psychological assessments...of Education/United States Secretary of Education. The psychology degree program must have been one that prepared graduates for… more
    New York State Civil Service (07/22/25)
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  • Medical Records Retrieval Representative

    Humana (Syracuse, NY)
    …and help us put health first** The Medical Records Retrieval Representative ( Risk Adjustment Representative 2) travels to provider offices within Upstate/Central ... Oneida, Onondaga, Oswego, St. Lawrence Medical Records Retrieval Representative ( Risk Adjustment Representative 2) + Travels up...+ This role is part of Humana's Driver safety program and therefore requires an individual to have a… more
    Humana (08/01/25)
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  • Certified Coding Specialist I- Health Plan- Remote

    UPMC (Pittsburgh, PA)
    …+ Code Inpatient, Outpatient, physician, and ED charts as necessary. + Assign Risk Adjustment HCC diagnoses by thoroughly reviewing all documentation in the ... for a Certified Coding Specialist I position in the Medicare HCC department. This is a full time position...procedure. + Review appropriate documents to accurately assign a Risk Adjustment HCC diagnosis. + Review coding… more
    UPMC (07/30/25)
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  • Associate Medical Director

    CenterWell (Daytona Beach, FL)
    …(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 (06/12/25)
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  • Physician Coder: Hospitalist

    MedKoder (Mandeville, LA)
    …company offers services including inpatient and outpatient facility coding, medical risk adjustment management, DRG coding management, coding education, clinical ... and management, diagnostics, surgeries, and procedures in compliance with applicable Medicare , Medicaid, and third-party payer guidelines to ensure receipt of… more
    MedKoder (07/24/25)
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  • Case Manager

    Actalent (Sacramento, CA)
    …Case Manager is responsible and accountable for coordination of services for Medicare client members referred for complex case management. The Senior Nurse Case ... organized, multi-disciplinary, patient centered team approach, and cost-effective care for Medicare Client members. The Senior Nurse Case Manager follows and manages… more
    Actalent (07/22/25)
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  • Social Worker

    Catholic Health Initiatives (Omaha, NE)
    …of the Social Worker include: crisis intervention, patient/family intervention, high- risk screening, brief counseling, referrals for financial or other identified ... discharges and engagement of appropriate agencies or community resources when high- risk patients are identified. **E** **SSENTIAL** **K** **EY** **J** **OB** **R**… more
    Catholic Health Initiatives (07/22/25)
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  • Medical Director - Dsnp/MMP

    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
    CVS Health (07/18/25)
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  • Behavioral Health Care Coordinator

    Actalent (Sunrise, FL)
    …mental illness (SMI). Responsibilities + Lead a multidisciplinary team to identify high- risk clients, address care gaps, and collaborate with providers to enhance ... admissions and placements. + Conduct thorough needs assessments, including risk stratification, to determine health, psychological, educational, and social needs.… more
    Actalent (07/30/25)
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  • Clinical Documentation Integrity Lead - Service…

    Stanford Health Care (Palo Alto, CA)
    …education, preferred. + Experience with Vizient, Premier, Elixhauser and other risk adjustment methodologies, highly preferred. **Required Knowledge, Skills and ... and application of CDI practices, coding rules and regulations, and conducts risk assessments of potential and detected compliance deficiencies, as well as… more
    Stanford Health Care (07/26/25)
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