- Centene Corporation (Tallahassee, FL)
- …States.** **Position Purpose:** Manages a team responsible for supporting key elements of the Risk Adjustment Compliance program with a focus on the auditing ... to the Risk Adjustment department. + Monitors and reviews risk adjustment activities to ensure compliance with federal and state regulations. +… more
- Evolent (Tallahassee, FL)
- …Be Doing:** ** Manager , Coding Support Specialist** Evolent Care Partners is seeking a Risk Adjustment Coding Support Manager to be a core member of ... to providing better health outcomes for the population. The Risk Adjustment Coding Manager plays...a crucial role in ensuring accurate medical coding and compliance with risk adjustment models.… more
- Datavant (Tallahassee, FL)
- …life experiences to realize our bold vision for healthcare. **Role Overview** As a Product Manager , Risk Adjustment Coding Data Integration, you will own the ... data strategy and execution for Datavant's Retrospective Risk Adjustment Coding products, driving client data standardization, data integrations, database… more
- Molina Healthcare (St. Petersburg, FL)
- … Manager - Provider Engagement** plays a key role in driving risk adjustment and quality performance outcomes through effective program management, ... Development** + Develop, review, and update Standard Operating Procedures (SOPs) for risk adjustment and quality program workflows. + Maintain accurate,… more
- Molina Healthcare (FL)
- …SKILLS & ABILITIES:** * 2+ years of program and/or project management experience in risk adjustment and/or quality * 2+ years of experience supporting HEDIS ... **Job Description** **Job Summary** The Risk & Quality Performance Manager position...engine activity, risk adjustment targeting and reporting systems *… more
- Bristol Myers Squibb (Tampa, FL)
- …. Bristol Myers Squibb (BMS) is seeking a candidate for the position of Senior Manager , Procurement, Third Party Risk Management. The Senior Manager will ... and functional SOPs. On the on-going base the Senior Manager ensures compliance to TPRM requirements within...interacting with all key stakeholders and SMEs from involved risk areas (IT, Quality, Corporate Security, EOHSS, Compliance… more
- Amazon (FL)
- …for handling new issues that arise in a business-centric way while addressing risk . Typical transactions will range from standard claims settlement to complex high ... to program goals. * Support internal audits to ensure quality and compliance are in accordance with client service instructions and performance expectations. *… more
- Datavant (Tallahassee, FL)
- …The individual will provide superior quality by performing audits pertaining to risk adjustment coding efforts. The individual will be responsible for ... program + Play a key role in ensuring coding compliance and accuracy + Monitor the performance of the... and accuracy + Monitor the performance of the Risk Adjustment Operations both internally and with… more
- AdventHealth (Maitland, FL)
- …in understanding professional and facility claims and managed care concepts such as risk adjustment , capitation, FFS, DRG, APG, APCs and other payment mechanisms ... of managed care contracts, proposals, analyze fee schedules, and determine contract compliance . The Medical Economics Manager must have attention to detail… more
- AdventHealth (Orlando, FL)
- …emergency cases: 89,018 **The role you'll contribute:** The Social Work Care Manager intervenes with patients who have complex psychosocial needs, require assistance ... the development of a discharge plan of care for high- risk patient populations. This role will receive referrals for...members of the care team). The Social Work Care Manager , in collaboration with the patient/family, care manager… more
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