- CareFirst (Baltimore, MD)
- …**Preferred Qualifications:** + Experience in healthcare industry and deep understanding of Medicare risk adjustment (clinical, submission cycle, and ... **Resp & Qualifications** **PURPOSE:** The Quality, Stars, and Risk Adjustment Analytics team is hiring a lead data analyst with deep experience in risk … more
- UCLA Health (Los Angeles, CA)
- Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment , you will be an expert in risk adjustment coding ... and documentation, working closely with physicians, IPA coders, and risk adjustment teams associated with the health plan. You will: + Conduct medical record… more
- UCLA Health (Los Angeles, CA)
- Description As the Medicare Advantage Risk Adjustment Performance Improvement Consultant, you will be responsible for: + Serving as a Subject Matter Expert ... (SME) for risk adjustment with contracted IPAs + Collaborating...experience * Knowledge of HIPAA regulations * Knowledge of Medicare Advantage, STARS/HEDIS program, and NCQA technical specifications, a… more
- Elevance Health (Mason, OH)
- …effectively consult and guide internal stakeholders on effective use and interpretation of risk adjustment data and KPIs + Provides expertise to lower-level ... Medicare is strongly preferred + Healthcare business knowledge related to Risk Adjustment Payment Methodology strongly preferred + Advanced skills in… more
- Highmark Health (Pittsburgh, PA)
- …At least five years' direct management experience Preferred: + 5 or more years' Medicare and/or Commercial risk adjustment experience + Previous involvement ... Development and Management: + Provide strategic leadership and management for the Risk Adjustment Accuracy Management Department. + Develop and oversee programs… more
- Robert Half Accountemps (Long Beach, CA)
- …for leading enterprise development of the Medicare Star Ratings and Enterprise Risk Adjustment strategies that ensure our risk adjusted and Star ... and military experience will be considered. . Strong knowledge of Medicare Star Ratings and risk adjustment programs. . Demonstrated ability to lead… more
- Datavant (Trenton, NJ)
- …+ Knowledge and understanding of HCC mapping and models + Experience with coding Medicare , Commercial and Medicaid risk adjustment charts + Understanding of ... Medicare , Commercial and Medicaid risk adjustment business logic and coding + Knowledge and understanding of health insurance plans operations + Deep… more
- VNS Health (Manhattan, NY)
- …records, including ICD 10 CM or current coding system and medical record systems for Medicare Advantage Risk Adjustment required + 2 years of experience in ... identifying opportunities to support precise clinical documentation. Collaborating with the Risk Adjustment and Quality teams, you'll help shape educational… more
- System One (Baltimore, MD)
- …of experience as a Data Analyst. + 3-5 years of hands-on experience specifically in Medicare Risk Adjustment . + Strong understanding of CMS guidelines, RA ... making better business decisions. The individual will interpret and apply Medicare Advantage Risk Adjustment rules, regulations, and processes in analytics… more
- Apex Health Solutions (Houston, TX)
- …Current AAPC or AHIMA credential required. Managed Care Experience preferred. Knowledge of Medicare Risk Adjustment required. About Apex Health Solutions ... Specialist Supervisor: Director, VBC Operations Required License(s)/ Certification(s): Certified Risk Adjustment Coder (CRC), Certified Professional Coder (CPC),… more
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