- CenterWell (Tallahassee, FL)
- **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
- Elevance Health (Tampa, FL)
- …effectively consult and guide internal stakeholders on effective use and interpretation of risk adjustment data and KPIs + Provides expertise to lower-level ... Medicare is strongly preferred + Healthcare business knowledge related to Risk Adjustment Payment Methodology strongly preferred + Advanced skills in… more
- Datavant (Tallahassee, FL)
- …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
- AdventHealth (Maitland, FL)
- …Accountable for improvement in clinical documentation accuracy through oversite of the risk adjustment team, including accountability for: o Ensuring clinical ... also oversee the improvement of clinical documentation accuracy for Medicare and Exchange members. While under the direction of...in place for the accurate and complete reporting of Risk Adjustment Factor (RAF) scores. o Driving… more
- CVS Health (Tallahassee, FL)
- …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
- CenterWell (Tallahassee, FL)
- …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
- Elevance Health (Tampa, FL)
- …to the development and implementation of strategic initiatives aimed at improving risk adjustment outcomes. + Monitor the effectiveness of implemented solutions ... to identify trends, areas for improvement, and opportunities within Medicare markets ad provider networks. + Gather and analyze...stakeholders + Serves as a subject matter expert on Risk Adjustment programs and risk … more
- Humana (Tallahassee, FL)
- …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 (Tallahassee, FL)
- …+ 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 (Tallahassee, FL)
- …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
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