- Highmark Health (Providence, RI)
- …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
- CenterWell (Providence, RI)
- …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
- Centene Corporation (Providence, RI)
- …refining Medicare contract models, incorporating CMS and NYSDOH guidelines related to risk adjustment , quality metrics, and financial benchmarks. + Collaborate ... data visualizations, and summaries to support contract negotiations, governance discussions, and strategic planning led by the Medicare VBP Manager . + Advance… more
- CenterWell (Providence, RI)
- …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 (Providence, RI)
- …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
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