- Elevance Health (Mason, OH)
- …presentation, and problem-solving, critical thinking skills strongly preferred. + Healthcare business knowledge related to Risk Adjustment Payment ... to the development and implementation of strategic initiatives aimed at improving risk adjustment outcomes. + Monitor the effectiveness of implemented solutions… more
- Datavant (Columbus, OH)
- … adjustment charts + Understanding of Medicare , Commercial and Medicaid risk adjustment business logic and coding + Knowledge and understanding of ... Ciox core values to all members of Ciox team + Expertise and understanding of risk adjustment business logic + Ability to analyze data to determine the root… more
- Elevance Health (Mason, OH)
- …Knowledge of SAS and SQL. + Ability to manage multiple projects simultaneously. + Medicare risk adjustment experience highly preferred. Please be advised ... ** Business Change Manager** **Location:** Grand Prairie, TX; Indianapolis,...and resources + Leading various projects that support the Medicare Risk & Recovery Revenue Management -… more
- Elevance Health (Mason, OH)
- …+ Working knowledge of Medicare is strongly preferred + Healthcare business knowledge related to Risk Adjustment Payment Methodology strongly ... effectively consult and guide internal stakeholders on effective use and interpretation of risk adjustment data and KPIs + Provides expertise to lower-level… more
- Humana (Columbus, OH)
- …+ Demonstrating an understanding of departmental and organizational goals and how risk adjustment compliance supports boarder business priorities. Making ... caring community and help us put health first** The Risk Adjustment Compliance Professional 2 supports the...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- CVS Health (Columbus, OH)
- …Health has an exciting opportunity for an Informatics Manager to join our dynamic Risk Adjustment Analytics team! In this role, you will support data analysis, ... business needs. You will be responsible for maintaining risk score model integrity across multiple states and communicate...Knowledge of health insurance concepts - Experience working in risk adjustment - Experience working at a… more
- CVS Health (Columbus, OH)
- …Programs experience including Medicare , Commercial ACA, and/or Medicaid. + Risk adjustment working knowledge and understanding. + Process development and ... and target/actual dates of completion. + Support provider performance that improves risk score accuracy through meaningful engagement. + Manage project timelines and… more
- Humana (Columbus, OH)
- …**Preferred Qualifications** + Experience in Medicare Advantage - risk adjustment or Stars + Degree in business , finance, analytics, or related field; ... Finance team supports Humana's Healthcare Quality Reporting and Improvement business area, part of the Medicare and...Medicaid regulations and payment models, monitors and reports on risk adjustment data submissions, and supports HQRI… more
- Molina Healthcare (Dayton, OH)
- …HMO regulations, managed healthcare systems, quality improvement, medical utilization management, risk management, risk adjustment , disease management, and ... medical director, and quality improvement staff. + Facilitates conformance to Medicare , Medicaid, NCQA and other regulatory requirements. + Reviews quality referred… more
- Cognizant (Columbus, OH)
- …and TriZetto implementation methodology around enrollment, reconciliation, encounters and risk adjustment programs in the government sponsored healthcare ... healthcare and government programs particularly within enrollment, reconciliation, encounters and risk adjustment areas. . Strong capabilities and experience in… more
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