- Humana (Harrisburg, PA)
- **Become a part of our caring community and help us put health first** The Risk Adjustment Compliance Professional 2 supports the organization's ... guidance, and sound judgement in determining appropriate actions within established framework. The Risk Adjustment Compliance Professional 2 contributes… more
- Highmark Health (Harrisburg, PA)
- …This job provides end-to-end management, delivery and support to new and existing Risk Adjustment Programs. The incumbent will deliver value to the Health ... business outcomes and achieve strategic objectives relative to new and existing Risk Adjustment Programs. Supports other key objectives designed to… more
- Datavant (Harrisburg, PA)
- …using a standardized system, ensuring accurate representation of patient conditions for risk adjustment and reimbursement purposes. You will play a critical ... complex problems with technology-forward solutions. Datavanters bring a diversity of professional , educational and life experiences to realize our bold vision for… more
- RELX INC (Philadelphia, PA)
- …our GRC team? About the role: We are seeking an experienced Senior Governance, Risk , and Compliance (GRC) Analyst to lead the development and implementation of ... The successful candidate will have a deep understanding of cybersecurity frameworks, risk management, and compliance standards, and will work collaboratively… more
- Humana (Harrisburg, PA)
- …and Medicaid regulations and payment models, monitors and reports on risk adjustment data submissions, and supports HQRI operations. **Responsibilities** ... factors **Preferred Qualifications** + Experience in Medicare Advantage - risk adjustment or Stars + Degree in...the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and… more
- Commonwealth of Pennsylvania (PA)
- …and interpreting standardized tests of personality, interest, intelligence, achievement and/or risk assessment. + B. I have professional experience related ... designs and/or conducting research in fields of personality development and adjustment , diagnosis, risk assessment, treatment and prevention of mental… more
- CVS Health (Harrisburg, PA)
- …Sr 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
- Commonwealth of Pennsylvania (PA)
- …agency compliance with established accounting standards. Identifies areas of risk related to the accuracy and completeness of financial statements and reports. ... funds. I was responsible for developing and implementing procedures to eliminate unacceptable risk . + B. I have experience monitoring compliance with established… more
- Commonwealth of Pennsylvania (PA)
- …and interpreting standardized tests of personality, interest, intelligence, achievement, and/or risk assessment. + B. I have professional experience related ... services to address the mental health and general emotional adjustment needs of the inmate population at SCI Coal...licensure as a Social Worker, Clinical Social Worker, or Professional Counselor issued by the Pennsylvania State Board of… more
- RELX INC (Philadelphia, PA)
- …matter expertise for Transaction Monitoring (TM) initiatives across the Financial Crimes Compliance (FCC) division of LexisNexis Risk Solutions. In this role, ... About the Business LexisNexis Risk Solutions is the essential partner in the...all functions including product, technology, data operations, marketing, and professional services to ensure an end-to-end focus for data,… more