- CenterWell (Tampa, FL)
- …a value-based primary care setting. This role uses clinical expertise and knowledge of risk adjustment and coding to present educational materials in a way that ... clinicians, presenting education that aligns with value-based care priorities like risk adjustment accuracy, quality performance, compliance, and effective… more
- CenterWell (Tallahassee, FL)
- …interrelate across the function or segment. **Strategy:** + In partnership with AVP, Risk Adjustment and AVP, MRA Strategy, responsible for driving ongoing ... + Responsible for performance management and strategy development for PCO risk adjustment at the division and market level; Partners with Clinical Documentation… more
- Hartford HealthCare (Farmington, CT)
- …documentation practices that comply with CMS on evaluation and management, procedure, risk adjustment program requirements and ICD 10 coding guidelines. ... audit requirements. 6. Identify process improvements to capture data for Medicare Risk Adjustment and help providers code to the level of specification 7. Builds… more
- Humana (Fort Lauderdale, FL)
- …Professional Coder) Certification + 4 or more years of medical coding experience + Risk Adjustment knowledge + Proficiency with data analytics tools (such as ... data sets **Preferred Qualifications** + Bachelor's Degree + CRC -Certified Risk Adjustment Coder + Experience interacting with healthcare providers + Strong… more
- East Boston Neighborhood Health Center (Revere, MA)
- …state PACE financial requirements, including budgeting, encounter reporting, capitation reconciliation, risk adjustment , and cost allocation. + Serve as internal ... PACE regulations, 340B program, and Medicaid/Medicare reimbursement + Third-party billing, risk adjustment , and alternative payment methodologies + Grants… more
- Ankura (Los Angeles, CA)
- …assessment. + Apply innovative techniques to healthcare engagements including those related to Risk Adjustment . + Expand and build new products in a ... an Industry thought leader in healthcare topics like predictive analytic applications, risk adjustment , and value-based care. + Develop, supervise, and motivate… more
- Ankura (VA)
- …processing and payment, provider contracts, market pricing, benefits administration, billing and coding, risk adjustment , etc. + Expand and build new products in ... in emerging healthcare topics driving the industry like predictive analytic applications, risk adjustment , and value-based care. + Develop, supervise, and… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …cost saving opportunities. * Works closely with actuarial, finance, data & analytics, stars, risk adjustment , and other lever owners to gather necessary data for ... to established contracts. * Collaborate with actuarial, finance, Medicare and risk adjustment to ensure all inputs and assumptions leverage BlueCross source of… more
- Deloitte (Los Angeles, CA)
- …reimbursement, MS-DRG, APR-DRG, PSIs, HACs, POA, Vizient, Elixhauser, public profiling, and risk adjustment + Has strong interpersonal skills to collaborate with ... Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk & Forensic team helps client leaders translate multifaceted risk … more
- Humana (Indianapolis, IN)
- …of experience in root cause analysis, inner working of provider office and systems, or risk adjustment . + Proven ability to compare, read, and report on claims ... related field. + Python, SQL, Databricks, or Power BI experience. + Risk adjustment background or knowledge. + Experience in provider office environments and… more