- TEKsystems (Sunrise, FL)
- …are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the ... disability * Health Spending Account (HSA) * Transportation benefits * Employee Assistance Program * Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This… more
- TEKsystems (Sunrise, FL)
- …are subject to change and may be subject to specific elections, plan, or program terms. If eligible, the benefits available for this temporary role may include the ... disability * Health Spending Account (HSA) * Transportation benefits * Employee Assistance Program * Time Off/Leave (PTO, Vacation or Sick Leave) Workplace Type This… more
- Fallon Health (Worcester, MA)
- …of employee's time)** With demonstrated and proven success in government & state sponsored risk adjustment program operations, the Senior Director of Risk ... quality outcomes and manage medical expense trends. + General Risk Adjustment Program Audit, Design,...Information Systems **Experience:** + 7-10+ years' experience in the risk adjustment and Medicare managed… more
- Molina Healthcare (NY)
- …Health Plan strategic analysis and planning and coordinates across business units on Risk Adjustment Program Valuation and Strategic/Scoreable Action Items ... analytic / programming tools as needed + Reporting includes Risk Adjustment program performance metrics,...risk models including the various CMS models for Medicare Advantage members, the HHS model for Commercial ACA… more
- Elevance Health (FL)
- …for completing projects and performing complex actuarial studies related to risk adjustment analytics in both the Medicaid and Medicare Advantage lines of ... to: + Analyzes and develops SAS and SQL programming to support Medicaid and Medicare Advantage risk adjustment initiatives. + Performs data mining and… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …updates, maintaining currency in coding. Evaluates, researches, and recommends enhancements to the risk adjustment program . * Proposes and develops new desk ... right for you, we encourage you to apply! Job Description: Summary: The Risk Adjustment Coding Coordinator is responsible for various aspects of decision-making… more
- CareFirst (Baltimore, MD)
- …risks or barriers to leadership to ensure that all risk adjustment activities fully comply with Medicare , Medicaid, ACA, and state-specific regulations. ... **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Operations Supervisor supports...Adjustment . + Successful completion of a Coding Certificate program from an accredited organization (ie, CPC, CRC, CPMA… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Operations Manager plays a critical role in the development and execution of the corporate risk ... the end to end strategy by applying improvements and driving cost-effective risk adjustment actions across all organizational populations and products.… more
- Centene Corporation (Tallahassee, FL)
- …remote from home anywhere in the Continental United States.** **Position Purpose:** Supports the Risk Adjustment Compliance program elements, with a focus on ... adjustment regulatory landscape preferred + Risk Adjustment regulatory audit experience preferred + Medicare ...additional forms of incentives. Benefits may be subject to program eligibility. Centene is an equal opportunity employer that… more
- Molina Healthcare (Ridgeland, MS)
- **Job Description** **Job Summary** The AVP, Quality & Risk Adjustment is responsible for leading health plan execution for Risk Adjustment and Quality ... of strategy and activities with Enterprise, acting as the Risk Adjustment and Quality subject matter expert...MHI RQES and VP Stars in developing the local Medicare Stars work plan and executes on interventions that… more
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