- Highmark Health (Blue Bell, PA)
- …At least five years' direct management experience Preferred: + 5 or more years' Medicare and/or Commercial risk adjustment experience + Previous involvement ... financial returns in a fully compliant manner. Develop a Risk Management governance strategy for the Enterprise...Management: + Provide strategic leadership and management for the Risk Adjustment Accuracy Management Department. + Develop… more
- Datavant (Harrisburg, PA)
- …to realize our bold vision for healthcare. **Role Overview** As a Product Manager, Risk Adjustment Analytics Products, you will contribute to the strategy ... and execution of analytics capabilities that power Datavant's risk adjustment solutions. You'll drive the development of robust, scalable, and actionable… more
- Highmark Health (Pittsburgh, PA)
- …to Quality and Coding for the Highmark Health Enterprise. Ensures that Highmark's Risk Adjustment programs comply with all applicable guidelines, regulations and ... accuracy of medical record documentation and coding. Promotes the strategy and capabilities to develop risk management...a team of internal coder / clinicians that perform Risk Adjustment coding of medical records. Track… more
- Datavant (Harrisburg, PA)
- …outpatient or inpatient setting. + Current CCS, CRC, or CPC required. + Previous Medicare Advantage Risk Adjustment , CDI, Medicaid, Commercial RA, and HEDIS ... up to date with current coding policies for ICD-10, Medicare Advantage, HHS (ACA), and other markets. + Provide...clients understand the shifts and trends happening in the risk adjustment coding space. **What you will… more
- Humana (Harrisburg, PA)
- …in Medicare Advantage or Value-Based Care + AAPC CRC (Certified Risk Adjustment ) Certification + AAPC CDEO (Certified Documentation Expert Outpatient) ... across multiple assigned provider groups. This role contributes to departmental strategy and process improvements, makes decisions on moderately complex to complex… more