- 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
- CareFirst (Baltimore, MD)
- …models. Supports to use of alternatives and solutions to maximize quality payments and risk adjustment . Translates from claim language to services in an episode ... Coder (CCS or CPC)-AHIMA or AAPC **Experience:** 3 years' experience in risk adjustment coding, ambulatory coding and/or CRC coding experience in managed care;… more
- Humana (Alachua, FL)
- …community and help us put health first** The Medical Record Retrieval Specialist ( Risk Adjustment Representative 3) Travels to provider offices within the region ... records are reviewed by Humana's Coding staff. The Medical Record Retrieval Representative ( Risk Adjustment Representative 3): + Travel up to 60% of the time in… more
- Elevance Health (Norfolk, VA)
- …hospital medical records to ensure proper ICD-9 coding and compliance with risk adjustment requirements. **Location:** Virtual: This role enables associates to ... both revenue project and RADV. + Assists with National and Targeted Risk Adjustment Data Validation audits. + Participates and represents the department in… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …with a focus onaccurateandcompleteandMedicare Advantage (MA) data.You'llcollaborate withdataanalysts, actuaries, risk adjustment subject matter experts, other ... in healthcare data, regulatory reporting skills, and a solid grasp of risk adjustment methodologies. Essential qualifications include hands-on experience with… more
- Humana (Raleigh, NC)
- …advance their goals related to interoperability, quality, value-based arrangements, and risk adjustment strategies + Recommends execution strategies and monitor ... Health Care/Administration, RN or a related field + Experience with Medicare Risk Adjustment + Progressive experience with interoperability solutions in… more