- Humana (Raleigh, NC)
- …to drive efficient, effective, and compliant risk adjustment processes. This Risk Adjustment Risk Management lead position will be responsible ... Management Lead acts as a consultant to the Risk Adjustment team leaders, as programs and...Management and is responsible for oversight of the Risk Adjustment Operations processes. The Risk… more
- Centene Corporation (Raleigh, NC)
- …years Related IT experience, including data warehouse, coding or ETL required Medicare Risk Adjustment experience preferred **Project Management or Project ... perspective on workplace flexibility. **Position Purpose:** Executes Line 2 oversight of Risk Adjustment including monitoring, auditing, and Line 1 oversight.… more
- Baylor Scott & White Health (Raleigh, NC)
- …and external sources to provide insight to decision-makers. This role supports program management activities around risk adjustment data management ... procedure documentation. + Oversee updates to department policies and procedures regarding risk adjustment data management . + Remain current on CMS Risk… more
- UNC Health Care (Chapel Hill, NC)
- …the health and well-being of the unique communities we serve. Summary: The Risk Adjustment Coordinator will be responsible for analyzing and auditing medical ... required by the third party payer under the value care contracts. In addition, the Risk Adjustment Coordinator will be responsible for working the EPIC WQ to… more
- Datavant (Raleigh, NC)
- …and roadmap for the Data Integration pod within the Retrospective Risk Adjustment Coding Product Suite + **Client Data Management :** Oversee secure and ... to realize our bold vision for healthcare. **Role Overview** As a Product Manager, Risk Adjustment Coding Data Integration, you will own the data strategy and… more
- Datavant (Raleigh, NC)
- …and life experiences to realize our bold vision for healthcare. As an Auditor, HCC Risk Adjustment Coder, you will review medical records to identify and code ... using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical… more
- Datavant (Raleigh, NC)
- …vision for healthcare. We're looking for experienced and credentialed Auditing Team Lead, HCC Risk Adjustment Coding to become an integral part of our team. The ... for education opportunities in both quality and productivity to management for review and/or action. + Assists in auditing...95% or higher. + Any other tasks required by management . What you will bring to the table: +… more
- Datavant (Raleigh, NC)
- …for healthcare. Auditing Supervisor serves as a working supervisor with oversight and management of Risk Adjustment team members. This includes monitoring ... findings on a daily basis, including education on time management and best coding practices. + Provide coaching and...the role. + Report trends for education opportunities to management for review and/or action. + Motivate team members… more
- BlueCross BlueShield of North Carolina (NC)
- …of relevant actuarial experience. **Bonus Points** + Experience in Medicare Advantage Risk Adjustment highly preferred **What You'll Get** + The opportunity ... innovative insurance products, optimizing pricing strategies, or evaluating advanced care management models. Your work will support key organizational goals by… more
- Datavant (Raleigh, NC)
- …using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical ... skills, problem solve, ability to work in a remote environment, and time management skills. + Working knowledge of the business use of computer hardware and… more