- Fallon Health (Worcester, MA)
- …fallonhealth.org or follow us on Facebook, Twitter and LinkedIn. **Brief summary of purpose:** The Risk Adjustment Analyst (RAA) will be a SME for the ... MassHealth risk adjustment model(s) and related data submission requirements. This role will be familiar with all revenue streams relevant to the product line(s)… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …to blue. Position Summary: This role will provide analytical support to the Risk Adjustment Operations team. We're seeking a detail-oriented, curious, and ... data needs throughout program cycles. + Manage data requirements for different Risk Adjustment activities such as in-home health assessments, annual CMS and HHS… more
- Datavant (Boston, MA)
- …reports directly to the Director of Strategic Operations. As a trusted partner to the Risk Adjustment COO and broader leadership team, you'll play a key role in ... for delivering results **Bonus Points If:** + You have experience in risk adjustment coding applications and technology \#LI-BC1 We are committed to building a… more
- Point32Health (MA)
- …care claims data, coding schemes (ICD-9/ICD-10, CPT/HCPCS, DRGs), and health status risk adjustment . In-depth health care reimbursement and managed care business ... the Director or Senior Manager, the Senior Network Performance Analyst will be part of a team responsible for...and Reserving to ensure open communication relating to provider risk deals. + In-depth knowledge and understanding of managed… more
- Elevance Health (Woburn, MA)
- …of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), ... consolidating processes for forecast and month-end results. + Serve as an analyst and advisory to both internal and external stakeholders, developing value-based… more