- CenterWell (Atlanta, GA)
- **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
- Datavant (Atlanta, GA)
- …+ Knowledge and understanding of HCC mapping and models + Experience with coding Medicare , Commercial and Medicaid risk adjustment charts + Understanding of ... Medicare , Commercial and Medicaid risk adjustment business logic and coding +...other legally protected status. At Datavant our total rewards strategy powers a high-growth, high-performance, health technology company that… more
- Molina Healthcare (Atlanta, GA)
- …Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities. Ensures the ... Plan have engagement plans to meet annual quality and risk adjustment goals. Drives coaching and collaboration...Min 3 years experience improving Quality performance for Medicaid, Medicare , and/or ACA Marketplace programs To all current Molina… more
- Datavant (Atlanta, GA)
- …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
- CenterWell (Atlanta, GA)
- …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 (Atlanta, GA)
- …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 (Atlanta, GA)
- …experience in a health care and / or Insurance setting + Working knowledge of Medicare Risk Adjustment and/or Stars + Medical Coding Instructor Certification ... 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
- Highmark Health (Atlanta, GA)
- …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
- CenterWell (Atlanta, GA)
- …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
- Vatica Health (Alpharetta, GA)
- …billing, quality and Value Based Care measures and metrics. Risk Adjustment knowledge/experience is preferred. + Understanding of Medicare , ACD, Medicaid, ... issues. + Learn, understand, implement, and communicate all changes in strategy , technology, systems, workflows, policies, and procedures to appropriate team… more