- Genesis Healthcare (NM)
- …serve. Responsibilities Make a difference in patient care by joining our team as the Director of Clinical Risk Management. You will champion patient safety ... provide data-driven feedback. *Serve as a subject matter expert in clinical risk management, providing guidance and promoting best practices. *Support nursing… more
- Molina Healthcare (Las Cruces, NM)
- **Job Description** **Job Summary** The Director , Clinical Data Acquisition is responsible for the implementation, monitoring, and oversight of all chart ... collection for HEDIS, or HEDIS-like projects, Risk Adjustment, Risk Adjustment Data Validation, and...Molina plans. + Develops and implements targeted collection of clinical data acquisition related to performance reporting and improvement,… more
- Datavant (Santa Fe, NM)
- …life experiences to realize our bold vision for healthcare. **Role Overview** As the Director of Prospective + Concurrent Risk Adjustment Products, you will lead ... 8+ years of product management experience in healthcare, including ownership of clinical , risk adjustment, or provider-facing solutions. + Proven leadership… more
- Sumitomo Pharma (Santa Fe, NM)
- …highly motivated, and experienced individual for the position of **Associate Medical Director .** The Associate Medical Director will provide hands-on PVRM ... including signal detection, signal validation, signal escalation, development of risk mitigation strategies and authoring of signal evaluation reports according… more
- Highmark Health (Santa Fe, NM)
- …are performed in accordance with the highest and most current clinical standards. The incumbent reviews escalated cases electronically and using Medical ... management. They will advise the multidisciplinary team on cases, particularly high- risk cases, through the team structure. Additionally, the incumbent may be… more
- Molina Healthcare (Santa Fe, NM)
- …NCQA-compliant clinical quality improvement activity (QIA) in collaboration with the clinical lead, the medical director , and quality improvement staff. + ... + 3+ years relevant experience, including: + 2 years previous experience as a Medical Director in a clinical practice. + Current clinical knowledge. +… more
- Otsuka America Pharmaceutical Inc. (Santa Fe, NM)
- **Job Summary** We are seeking an experienced and dynamic Executive Director of R&D Global Quality to join our team. This pivotal role will be responsible for ... Quality will ensure OAPI, OPDC and all affiliates are inspection ready, oversee clinical trial and submission support, lead the R&D audit program, engage with… more
- Evolent (Santa Fe, NM)
- …and that impact the team. Provide individual and team training on clinical documentation requirements, risk adjustment coding guidelines, and updates. + ... quality checks for coding staff and practices to mitigate risk and ensure correct coding and clinical ...coding questions and issues. + Collaborate with the coding director to develop policies, procedures, and workflows to enhance… more
- Sedgwick (Santa Fe, NM)
- …Work(R) Fortune Best Workplaces in Financial Services & Insurance Sr VP Medical Director (Hourly) The ideal candidate would work 8-20 hours per week. **PRIMARY ... (1) to three (3) years utilization review experience and three (3) years clinical quality control. **Skills & Knowledge** + Knowledge of evidence-based guidelines +… more
- Evolent (Santa Fe, NM)
- …the mission. Stay for the culture. **Who You'll Be Working With:** The Director , Performance Suite Analytics, utilizes and develops analytic tools to solve complex ... on organizational performance and patient health. This role supports capitated risk and value-based strategy development, medical cost management activity, medical… more
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