- Datavant (Lincoln, NE)
- …to realize our bold vision for healthcare. **Role Overview** As a Product Manager, Risk Adjustment Analytics Products, you will contribute to the strategy ... and execution of analytics capabilities that power Datavant's risk adjustment solutions. You'll drive the development of robust, scalable, and actionable… more
- Molina Healthcare (GA)
- …well as automated analytical as well as Reporting modules related to Risk Adjustment for Medicaid, Marketplace and Medicare /MMP. + Assist Risk ... **Job Description** **Job Summary** The Analyst, Risk Adjustment -Predictive Analytics role will support Molina's Risk Adjustment Predictive Analytics… more
- Centene Corporation (Queens, NY)
- …+ Develop and refine Medicare contract models to incorporate RAF ( Risk Adjustment Factor) trends, Stars quality metrics, and benchmarking methodologies to ... execution of the organization's Value-Based Payment strategies (VBP) and other risk -based contracting strategies. + Oversee Medicare -specific VBP contracts,… more
- Centene Corporation (Providence, RI)
- … Medicare contract models, incorporating CMS and NYSDOH guidelines related to risk adjustment , quality metrics, and financial benchmarks. + Collaborate with ... with Contract management and Service Fund teams to implement monitoring of Medicare -specific VBP contracts, including models with upside/downside risk , shared… more
- AmeriHealth Caritas (Newtown Square, PA)
- …Summary** Reporting to the Senior Vice President, the Vice President, HEDIS / Stars Risk Adjustment Performance Strategy serves as the leader responsible for ... driving the Quality Performance Reporting & Analytics and Risk Adjustment for Medicaid Quality, Medicare...and Exchange QRS. This leader is accountable for driving strategy and insights for the local markets' quality intervention,… more
- Molina Healthcare (ID)
- …Azure, AWS, or Hadoop + 3-5 years of experience in Analysis related to HEDIS and/or Risk Adjustment + 3-5 years of experience in working with complex data to ... Educates users on how to use reports related to Risk and Quality/HEDIS for Medicaid, Marketplace and Medicare...users on how to use reports + Builds intervention strategy reporting for the Risk and Quality… more
- Molina Healthcare (Madison, WI)
- …+ Establishes strategy and operational direction for engaging providers on risk adjustment & quality improvement in collaboration with the Plan President, ... , and Network team. + Collaborates with Health Plan Network to drive value-based care strategy related to risk adjustment & quality. + Sets Health Plan… more
- Point32Health (NH)
- …and will work in a matrix environment collaborating with functions including risk adjustment , population health, finance, operations, actuarial, and sales. **Job ... **Job Summary** The Director of Contracting is responsible for contract strategy , development, negotiation, and implementation for hospitals, physician groups, and… more
- Humana (Topeka, KS)
- …+ A strong understanding of clinical metrics and data (eg Quality measures, Risk Adjustment ratings, chronic condition management, PCP visit rates and ... VP, Health Services relies on medical background to create and oversee clinical strategy for the region. The Regional VP, Health Services requires an in-depth… more
- CenterWell (Jacksonville, FL)
- …(clinical, financial, operational) meetings on key topics such as Medical Risk Adjustment (MRA), budgeting, staffing, operational excellence, and clinical ... organizational & market priorities, trends, and goals, to develop a clinical strategy to advance clinical talent and performance + Interview, hire, and supervise… more