- 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
- 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
- Saint Francis Health System (Tulsa, OK)
- …oversight to Population Health's clinical teams including quality, care management, pharmacy, risk adjustment program , and post-acute care initiatives. ... value-based contracts, to include but not limited to, Community Care of Oklahoma, Medicare ACO, Saint Francis's employer-sponsored health plan, and other at risk … more
- CVS Health (Phoenix, AZ)
- …consulting, financial strategic analysis. + Understanding of value-based care, including risk adjustment methodologies (eg, HCC coding), quality measurement ... development of provider performance improvement initiatives + Establish a program management framework for VBC improvement initiatives-- monitoring the impact… more
- Dana-Farber Cancer Institute (Brookline, MA)
- …to handle incoming patient-related calls, manage credit and collections activities, coordinate the Medicare Bad Debt program , copay assistance program , and ... backgrounds, and design programs to promote public health particularly among high- risk and underserved populations. We conduct groundbreaking research that advances… more
- Bristol Myers Squibb (Washington, DC)
- …policies. Develop and refine BMS positions on key issues including IRA implementation, Medicare Part B and D, 340B, and PBM reform. Oversee the drafting of ... and therapeutic policy teams to support portfolio access and mitigate policy risk . Collaborate with the USPGA Therapeutic Policy Lead to support product access… more
- Bristol Myers Squibb (Princeton, NJ)
- …role is responsible for contracting strategy and analytics for commercial and Medicare payers and also supports field-facing team members in contract negotiations. ... customer contracting opportunities including performing financial modeling and contract risk assessment analysis and preparation of legally approved contract… more
- Martin's Point Health Care (Portland, ME)
- …to their management and strategic deployment. + Provides support to Health Plan risk adjustment activities as needed. + Is conversant with Health Plan ... appeals of said services for clinical appropriateness and in compliance with government program rules + Contributes to case reviews to ensure the quality and safety… more
- Bristol Myers Squibb (Jacksonville, FL)
- …governing rules and laws. + Possess a strong understanding of Commercial payers, Medicare plans and state Medicaid in geography. + Immunology experience (emphasis on ... by your state of residence; and 3) a driving risk level deemed acceptable by the Company. Why You...Wellbeing support such as the BMS Living Life Better program and employee assistance programs (EAP). Financial well-being resources… more
- Henry Ford Health System (Southfield, MI)
- …Provide strategic oversight of health plan operations, including utilization management, risk adjustment , reimbursement strategy, and quality performance. + ... success leading complex, multi-site organizations in regulated environments such as Medicare Advantage, Medicaid, or integrated delivery systems. + Strong experience… more