- Convey Health Solutions (Fort Lauderdale, FL)
- …solutions that span the entire member lifecycle--from enrollment and billing to risk adjustment , Stars performance, and member engagement. Pareto's deep ... and operations teams to align prospecting activities with campaigns and content strategy . + Assist in preparation for and participation in field activities such… more
- CenterWell (Daytona Beach, 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
- CenterWell (Hampton, VA)
- …(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
- Molina Healthcare (Des Moines, IA)
- …of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), ... JOB DESCRIPTION Job Summary Provides executive level strategy and leadership for team responsible for medical...improve financial performance. * Advanced understanding of Medicaid and Medicare programs or other health care plans. * Advanced… more
- Humana (Washington, DC)
- …organizational Transformation + Payor/provider experience, includingproduct design, quality programs, risk adjustment , population health, member / patient ... for the company's future. Transformation is critical to our core strategy : delivering great healthcare to seniors, providing a differentiated healthcare experience,… more
- Convey Health Solutions (Fort Lauderdale, FL)
- …solutions that span the entire member lifecycle--from enrollment and billing to risk adjustment , Stars performance, and member engagement. Pareto's deep ... high-performing teams of 5-8 engineers. The Lead Data Engineer translates business strategy into data engineering execution, guiding the team in the adoption of… more
- Molina Healthcare (Dane, WI)
- …physical examinations. * Captures and documents annual diagnoses accurately consistent with Medicare risk adjustment . * Conducts comprehensive annual ... interdisciplinary team facilitating care across the continuum. Contributes to overarching strategy to provide quality and cost-effective member care. Essential Job… 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 ... clinical oversight of DSNP/MMP complex populations (Dual-Eligible Special Needs Plan / Medicare -Medicaid Plan) * Develop and lead clinical strategy and… more
- Humana (Trenton, NJ)
- …Electronic Medical Records, and/or Electronic Notifications. + Familiarity with CMS Risk Adjustment and Quality Measure Reporting. + Experience in ... for development team members based on Humana's LPM (Lean Portfolio Management) strategy with a top-down value approach. + Manage technical relationships with… more
- Dignity Health (Bakersfield, CA)
- …and dual eligible populations, and benefit systems is preferred. - HEDIS/Stars and HCC/ Risk adjustment knowledge. \#LI-DH **Where You'll Work** The purpose of ... needed to enhance the networks. They collaborate with Clinical Analytics, Clinical Strategy , and Quality Management to develop and enhance member health and wellness… more