- Highmark Health (Santa Fe, NM)
- …may have budgetary responsibility and authority. + Lead the day-to-day execution of Strategic Risk Adjustment Program engagements taking ownership of the ... end-to-end management, delivery and support to new and existing Risk Adjustment Programs. The incumbent will deliver... strategic objectives relative to new and existing Risk Adjustment Programs. Supports other key objectives… more
- Molina Healthcare (Las Cruces, NM)
- …SKILLS & ABILITIES:** * 2+ years of program and/or project management experience in risk adjustment and/or quality * 2+ years of experience supporting HEDIS ... **Job Description** **Job Summary** The Risk & Quality Performance Manager position...engine activity, risk adjustment targeting and reporting systems *… more
- CVS Health (Santa Fe, NM)
- … Manager , within the Revenue Integrity organization, you will be leading Risk Adjustment technical activities not limited to, reconciliation and aggregation, ... external consultants, team members and/or matrixed staff as required to support MA Risk Adjustment Revenue Integrity initiatives. + Responsible for leading the… more
- LifePoint Health (Las Cruces, NM)
- …compensation and episode of care payment Familiar with patient and practice risk adjustment mechanics and premium-based payment methodologies. Familiar with ... colonoscopies, cervical cancer screenings, and mammograms. The Quality Practice Manager (QPM) will collaborate with employed practices to achieve...patient and practice risk adjustment mechanics, APR; HCC/RAF Familiar with… more
- Amazon (Los Lunas, NM)
- …is seeking an experienced and innovative Senior Site Workplace Health and Safety (WHS) Manager to join our team. In this position, you will be responsible for ... you will lead continuous improvement initiatives to reduce conditional and ergonomic risk in Amazon's processes to ensure a safe and healthful working environment… more
- CenterWell (Santa Fe, NM)
- …help us put health first** The Finance Strategy Lead - MRA in the PCO risk adjustment area implements and supports strategy and targeted initiatives aimed at ... clinical efficiencies, processes, education, and compliance as it relates to Medicare Risk Adjustment . Uses data-based insight to direct process improvement… more
- CenterWell (Santa Fe, NM)
- …in value-based care, especially Medicare Advantage, with familiarity of HEDIS/STARS, medical risk adjustment , and clinical programming in primary care, complex ... to strengthen a patient-centered culture that is clinically led + Strategic problem-solver with examples of driving change initiatives with measurable impact… more
- Travelers Insurance Company (Santa Fe, NM)
- …for specific activities required to effectively evaluate claims, such as Subro, Risk Control, nurse consultants, the Travelers Lab, Claim Legal, and fire or ... + Effectively and efficiently manage both allocated and unallocated loss adjustment expenses + Evaluate all claims for recovery potential; directly handle… more