- Point32Health (Canton, MA)
- …and best practices; utilize this knowledge to recommend modifications to Point32Health's risk adjustment programs and provider engagement practices + Support the ... individual will support the operations and analysis of all risk adjustment programs and serve as the primary point...of contact to a select portion of our provider network . This includes strategically important business partners, such as… more
- Somatus (Mclean, VA)
- …+ Community engagement opportunities + And more! The Director, Medicare Risk Adjustment (MRA) will lead the execution strategy and implementation of the ... establish risk adjustment analytics such as predictive modeling for coding improvement opportunities, provider coding improvement opportunities, provider … more
- Humana (Columbus, OH)
- …responsible for driving provider performance programs, goals and improvement metrics for network providers and partnerships. The Engagement Professional is an ... Network Optimization, Clinical Services, Value-Based contracting, HEDIS and Risk Adjustment. Reporting to the Associate Director and/or Market Development… more
- Capital One (Mclean, VA)
- Center 1 (19052), United States of America, McLean, Virginia Manager, Cyber Risk & Analysis- Technology Audit (Hybrid) **Capital One's Audit function is a dedicated ... including critical technology functions, cloud-based infrastructure, emerging technology, cybersecurity, risk management, application, and third-party management, as well as… more
- Capital One (Mclean, VA)
- …security, network security, cyber security, data protection), information systems risk management, information systems auditing, or a combination + At least 1 ... Center 1 (19052), United States of America, McLean, Virginia Principal Associate Cyber Risk & Analysis, Technology Audit (Hybrid) Capital One's Audit function is a… more
- LA Care Health Plan (Los Angeles, CA)
- Provider Network Account Manager III Job Category: Administrative, HR, Business Professionals Department: Provider Network Management Location: Los Angeles, CA, ... to support the safety net required to achieve that purpose. Job Summary The Provider Network Account Manager III is responsible for all aspects of the LA Care (LAC)… more
- Centene Corporation (Wichita, KS)
- …Acts as a liaison between Tier II providers (large PCP groups not on risk contracts and providers with upside only incentives) and the health plan. Manages ... Network performance for assigned territory through a consultative/account management...approach. Drives provider performance improvement in the following areas: Risk /P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost and utilization,… more
- Centene Corporation (Salem, OR)
- …Acts as a liaison between Tier II providers (large PCP groups not on risk contracts and providers with upside only incentives) and the health plan. Manages ... Network performance for assigned territory through a consultative/account management...approach. Drives provider performance improvement in the following areas: Risk /P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost and utilization,… more
- Centene Corporation (Tallahassee, FL)
- …education, including writing and updating orientation materials + Manages Network performance for assigned territory through a consultative/account management ... performance + Drives provider performance improvement in the following areas: Risk /P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost and utilization, etc. +… more
- Point32Health (Canton, MA)
- …data, coding schemes (ICD-9/ICD-10, CPT/HCPCS, DRGs), and health status risk adjustment + Prior experience with Business Intelligence tools such as ... here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** Reporting to the Vice President of Network and Provider Performance Management, the Director of Network … more