- UCLA Health (Los Angeles, CA)
- Description As the Clinical Documentation Integrity Specialist - Medicare Advantage Risk Adjustment , you will be an expert in risk adjustment ... and documentation, working closely with physicians, IPA coders, and risk adjustment teams associated with the health...(II), and HCPCS coding systems required + Knowledge of Medicare Advantage STARS/HEDIS program and NCQA technical… more
- UCLA Health (Los Angeles, CA)
- Description As the Business Data Analyst for our Medicare Advantage Risk Adjustment team, you will be responsible for producing accurate and insightful ... Serve as a key departmental resource for application use related to risk adjustment coding guidelines and gap closure reporting. Salary Range: $76,200 -… more
- CenterWell (Sacramento, CA)
- …outcomes + Ability to travel up to 20% **Preferred Qualifications** + Proven experience with Medicare Advantage risk adjustment functions. + Proven track ... entities within the Primary Care Organization. **Strategy:** + In partnership with AVP, Risk Adjustment and AVP, MRA Strategy, responsible for driving ongoing… more
- Datavant (Sacramento, CA)
- …an outpatient or inpatient setting. + Current CCS, CRC, or CPC required. + Previous Medicare Advantage Risk Adjustment , CDI, Medicaid, Commercial RA, and ... up to date with current coding policies for ICD-10, Medicare Advantage , HHS (ACA), and other markets....clients understand the shifts and trends happening in the risk adjustment coding space. **What you will… more
- Datavant (Sacramento, CA)
- …to realize our bold vision for healthcare. **Role Overview** As a Product Manager, Risk Adjustment Analytics Products, you will contribute to the strategy and ... execution of analytics capabilities that power Datavant's risk adjustment solutions. You'll drive the development...measure product impact, and support value-based client delivery across Medicare Advantage , ACA, and Medicaid programs. The… more
- Sutter Health (Emeryville, CA)
- …population health, or value-based care environments. + Demonstrated success in managing Medicare Advantage or other risk -based contracts. + Proven ... Stars, HEDIS, and regulatory requirements for Medicare Advantage and commercial plans. + Expertise in risk... Advantage and commercial plans. + Expertise in risk - adjustment methodologies and clinical documentation accuracy. +… more
- Sutter Health (Sacramento, CA)
- …International Classification of Disease Coding ICD-10-CM and Current Procedural Terminology (CPT), Medicare Advantage , ICD-10-CM, and Centers for Medicare ... procedures. Responsible for pre-appointment review of each encounter in scope, including Medicare Advantage encounters, to ensure accurate reporting of diagnoses… more
- WelbeHealth (Los Angeles, CA)
- …Excel, and financial modeling tools + Deep understanding of CMS risk adjustment , Medicaid rate-setting, and Medicare Advantage /Part D payment models + ... and financial analysis. This role will focus on overseeing capitation rates, risk adjustment methodologies, claims forecasting, and Incurred But Not Reported… more
- Dignity Health (Bakersfield, CA)
- …ad hoc analysis to demonstrate insights and trends related to patient engagement, Medicare risk adjustment , STARS/HEDIS, Medical management, and program ... data, including payer data sources, including but not limited to; Medicaid, Traditional Medicare , Medicare Advantage , value based programs, among others. 3.… more
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