- Molina Healthcare (Yonkers, NY)
- …and confirm required data elements. + Collaborate with internal teams-including IT, Risk Adjustment operations , and clinical teams-to ensure accurate ... Analyst will play a supporting role on the RADV ( Risk Adjustment Data Validation) team, assisting in...team, assisting in the execution of CMS and internal audit activities. This position contributes to the development of… more
- Ankura (New York, NY)
- …an accredited college/university + 8+ years of experience in Medicare Risk Adjustment operations , internal audit , or compliance either within industry or ... of activities: + Help clients manage proactive and reactive Medicare and Commercial Risk Adjustment compliance, audit , and investigation projects for… more
- Molina Healthcare (Yonkers, NY)
- …chart retrieval, file transmissions, and adherence to applicable timelines * Support all risk adjustment audit related projects to ensure goals, objectives, ... the daily operations of all aspects of risk adjustment data validation related activities, including,...adjustment payment in all markets * Performs monthly audit on internal Molina Coding Specialists * Audits external… more
- Molina Healthcare (Yonkers, NY)
- …for HEDIS, or HEDIS-like projects, Risk Adjustment , Risk Adjustment Data Validation, and other state specific audit projects and deliverables. This ... * Experience developing performance measures that support business objectives. + HEDIS Operations experience. + Risk Adjustment and Data Validation… more
- Ankura (New York, NY)
- …Adjustment Coding (CRC) with at least five (5) recent years of experience in HCC/ Risk Adjustment and/or RADV Audit Methodology + Associate's or Bachelor's ... deliver work and seeks to gain additional opportunities for development in a variety of risk adjustment related areas. Qualifications: + Certified in Risk … more
- Amazon (New York, NY)
- …and customer obsessed Risk Specialist to join the Ads Trust Policy operations team. In this role, you will be an owner, responsible for ensuring that ... leads to realize efficiencies * Assess and evaluate opportunities and potential risk to business operations , including managing operational roadmaps, analyzing… more
- Molina Healthcare (Stamford, CT)
- …Center Operations , IT, Provider Configuration Management, Program Integrity, Risk Adjustment , Provider Resolution Team, Provider Appeal and Grievances, ... **Job Description** **Job Summary** Molina Health Plan Operations jobs are responsible for the development and administration of State Health Plan's operational… more
- Amazon (New York, NY)
- …change from the front of the pack. As an Amazon Logistics [AMZL] Operations Engineer, you will lead and manage the lifecycle of challenging cross-functional ... teams and outside vendors. * Promptly and accurately communicate project status, risk analysis and risk mitigation plans. Effectively answer project questions… more
- Amazon (Maspeth, NY)
- …change from the front of the pack. As an Amazon Logistics [AMZL] Operations Engineer, you will lead and manage the lifecycle of challenging cross-functional ... partner teams and outside vendors. *Promptly and accurately communicate project status, risk analysis and risk mitigation plans. Effectively answer project… more
- Amazon (New York, NY)
- …Basic Qualifications - 4+ years of compliance program management, legal, governance, audit , risk /loss prevention, or equivalent experience - Bachelor's degree or ... 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… more