- Highmark Health (Buffalo, NY)
- …the Organization are met or exceeded. Further, in a matrix management environment, the Medicare Advantage Quality Consultant is responsible for ... STARS, Medicaid HEDIS and risk revenue programs and clinical evidence-based guidelines.The Medicare Advantage Quality Consultant is expected to assess… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- … Quality and Manager (CHQM) * Registered Nurse * Solid knowledge of Medicare Advantage Business Compensation and Benefits: Pay Range: $88,600.00 - $117,400.00 ... Blue Cross and Blue Shield of Minnesota Position Title: Quality & Risk Adjustment Provider Consultant Location:...Position Title: Quality & Risk Adjustment Provider Consultant Location: Hybrid | Eagan, Minnesota Career Area: Customer… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …experience will be considered. * Experience in medical coding with a focus on Medicare Advantage and ACA risk adjustment. * Certified Risk Adjustment Coder (CRC) ... The Impact You Will Have As a Risk Adjustment Quality Assurance (QA) Consultant at BCBSMN, you'll...certification * In-depth knowledge of ACA & Medicare Advantage risk adjustment methodology, coding guidelines… more
- Health Care Service Corporation (Chicago, IL)
- …analysis for the Government Business segment, with a primary focus on the Medicare Advantage business. This role is responsible for developing in-depth medical ... company that will invest in your professional development. **Job Summary** The Senior Analytics Consultant - Medical Economics role supports medical cost trend… more
- Sedgwick (St. Paul, MN)
- …to Work(R) Fortune Best Workplaces in Financial Services & Insurance Litigated Claims Consultant (Examiner) | Public Entity | Remote **Are you looking for an ... global company known for its excellence and customer service. + Take advantage of a variety of professional development opportunities that help you perform… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …data analysis. This roleleveragesdeepexpertiseinRiskAdjustment and healthcare data-primarily Medicare Advantage , Medicaid, and ACA Commercial-identifyingtrends ... have experience inRiskAdjustment methodologies, clinical coding, and healthcare programs ( Medicare Advantage , Medicaid, ACA Commercial), as well asproficiencyin… more
- CenterWell (Morrow, GA)
- …of three to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice coding and documentation in value… more
- CenterWell (Anderson, SC)
- …of three to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice coding and documentation in… more
- CenterWell (Phoenix, AZ)
- …of three to five years directly applicable experience preferred + Experience managing Medicare Advantage panel of patients with understanding of Best Practice in ... + Knowledge of Medicare guidelines and coverage. + Knowledge of HEDIS quality indicators + Good understanding of best practice coding and documentation in value… more
- UNC Health Care (Morrisville, NC)
- …management of: commercial fee-for-service and value-based managed care payer contracts; Medicare Advantage and Managed Medicaid managed care fee-for-service and ... revenue that could cover any part of the managed care spectrum (commercial, Medicare Advantage , Medicaid Managed Care, specialty and carve-out services, direct… more
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