- 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
- Point32Health (Canton, MA)
- …and business division goals. This position will report to the Director of Risk Adjustment Strategy , Operations and Quality Assurance. **Job Description** ... will oversee all provider engagement and reporting activities for risk adjustment programs and initiatives that impact Medicare , Medicaid, and Duals product… more
- Ankura (New York, NY)
- …master's degree from an accredited college/university + 8+ years of experience in Medicare Risk Adjustment operations, internal audit, or compliance either ... compliance, accreditations, operations, investigations, and/or litigation/dispute matters generally focused on Medicare and Commercial Risk Adjustment . The… more
- Elevance Health (West Des Moines, IA)
- …for completing projects and performing complex actuarial studies related to risk adjustment analytics in both the Medicaid and Medicare Advantage lines of ... develops SAS and SQL programming to support Medicaid and Medicare Advantage risk adjustment initiatives....creating a culture that is designed to advance our strategy but will also lead to personal and professional… more
- CareFirst (Baltimore, MD)
- … Manager plays a critical role in the development and execution of the corporate risk adjustment strategy . The role serves as a dedicated resource within ... the organization for Medicare Advantage, Medicaid and ACA markets, coordinating and leading... strategy by applying improvements and driving cost-effective risk adjustment actions across all organizational populations… more
- CareFirst (Baltimore, MD)
- …risks or barriers to leadership to ensure that all risk adjustment activities fully comply with Medicare , Medicaid, ACA, and state-specific regulations. ... **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Operations Supervisor supports...Operations Supervisor supports the execution of the corporate coding strategy across Medicare Advantage, Medicaid, and ACA… more
- Humana (Harrisburg, PA)
- …focused in the areas of Provider Contracting, Provider Engagement and Quality, Risk Adjustment , Clinical, and Financial Operations. + Leadership development, ... initiatives to fruition. This includes the following key responsibilities: + Develop product strategy for annual Medicare Advantage plan filings + Lead the… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …+ Lead Product Strategy : Define and execute the roadmap for the Medicare Advantage Risk Adjustment solution, ensuring alignment with company goals ... a highly skilled and results-driven Senior Product Manager to lead our Medicare Advantage Risk Adjustment solution portfolio. In this critical role, you will… more
- Point32Health (Canton, MA)
- …for key initiatives + Serve as the key liaison for Actuarial, Finance, Risk Adjustment , Corporate Data and Analytics, Medical Cost Management, and Pharmacy ... years in Medicare Advantage, Medicaid managed care, or healthcare product strategy . + Preferred: 5 years of experience with D-SNPs or dual-eligible populations.… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …and vendor performance relative to established contracts. * Collaborate with actuarial, finance, Medicare and risk adjustment to ensure all inputs and ... to support Medicare network reviews. Inform the Medicare VBC strategy by projecting Medicare...Works closely with actuarial, finance, data & analytics, stars, risk adjustment , and other lever owners to… more
