• Medicare Risk Adjustment

    CenterWell (Phoenix, AZ)
    **Become a part of our caring community and help us put health first** The Medicare Risk Adjustment Strategy Lead in the PCO risk adjustment area ... at increasing clinical efficiencies, processes, education, and compliance as it relates to Medicare Risk Adjustment . Uses data-based insight to direct… more
    CenterWell (04/26/25)
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  • Manager, Risk Adjustment Analytics

    Datavant (Phoenix, AZ)
    …and managing in a remote environment (2+ years) + 3+ years of experience working with Medicare , ACA, and/or Medicaid risk adjustment models + 5+ years of ... vision for healthcare. **What we're looking for:** The incoming Risk Adjustment Analytics Manager will be stepping...with other managers and the department director to set strategy and mobilize the team to be as performant… more
    Datavant (04/17/25)
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  • Sr Mgr,Bus Consultant (IC)

    CVS Health (Phoenix, AZ)
    strategy discussions -Excellent communication, interpersonal, and presentation skills - Risk Adjustment HCC experience **Preferred qualifications:** ... Summary** : Serves as subject matter expert for the risk assessment of all Medicare Advantage, ACA/IFP,...data for multiple providers at market level to gauge risk adjustment improvement efforts. -Knowledge of payer… more
    CVS Health (04/25/25)
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  • IPA Coding Associate Director

    CenterWell (Phoenix, AZ)
    …within the Primary Care Organization. ** Strategy :** + In partnership with AVP, Risk Adjustment and AVP, MRA Strategy , responsible for driving ongoing ... Documentation (APD) tool) + Responsible for performance management and strategy development for PCO risk adjustment...up to 20% **Preferred Qualifications** + Proven experience with Medicare Advantage risk adjustment functions.… more
    CenterWell (04/24/25)
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  • Senior Financial Analytics Professional

    Humana (Phoenix, AZ)
    …factors. This position utilizes financial projection and analytics skills while working in Medicare risk adjustment . Additionally, you will work to build ... possess financial or actuarial background. Begins to influence department's strategy . Makes decisions on moderately complex to complex issues...working with Medical Claims or other healthcare data + Medicare Risk Adjustment Experience +… more
    Humana (05/03/25)
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  • Counsel

    Humana (Phoenix, AZ)
    …+ Demonstrated knowledge of Medicare Advantage program + Demonstrated knowledge of risk adjustment and the Stars quality program + Experience in managed care ... in a combination of disciplines. Begins to influence department's strategy . Makes decisions on moderately complex to complex issues...by: + Providing legal advice and support for Humana's Medicare Advantage lines of business; + Advising on … more
    Humana (05/01/25)
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  • AAPC Certified Medical Coding Instructor (CPC-i)

    Humana (Phoenix, AZ)
    …a focus on learning strategies and adult learning theories + Working knowledge of Medicare Risk Adjustment and/or Stars + Experience using Articulate ... solutions are necessary or relevant. Begins to influence department's strategy . Makes decisions on moderately complex to complex issues...Information This role will be responsible for supporting the Medicare Risk Adjustment Team within… more
    Humana (05/03/25)
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  • Value-Based Reimbursement Specialist

    Highmark Health (Phoenix, AZ)
    …in the organization's value-based reimbursement programs. Strong knowledge of risk adjustment methodologies and reporting/regulatory requirements and CMS ... central role in the development and execution of the strategy for a given initiative for transformation of workflows...outcomes strategic plan development. + 1 year experience with Medicare STARS, Medicaid HEDIS, risk revenue value… more
    Highmark Health (04/17/25)
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  • VP, Centerwell PCO, IPA CMO

    CenterWell (Phoenix, AZ)
    …care, especially Medicare Advantage, with familiarity of HEDIS/STARS, medical risk adjustment , and clinical programming in primary care, complex care, ... strong emphasis on senior-focused primary care for members of Medicare Advantage health plans and is committed to providing...develop and support the MSO's National Clinical Vision and Strategy , directly lead a team of regional & area… more
    CenterWell (04/24/25)
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  • Senior Medical Director, Network Performance

    Banner Health (Phoenix, AZ)
    …This role leads enterprise strategies to improve cost efficiency, quality outcomes, risk adjustment accuracy, and contract performance across lines of business ... clinical engagement, the Senior Medical Director will ensure Banner's network strategy consistently delivers measurable value for patients, providers, and the… more
    Banner Health (04/25/25)
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