- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …be considered. * Experience in medical coding with a focus on Medicare Advantage and ACA risk adjustment . * Certified Risk Adjustment Coder (CRC) ... certification * In-depth knowledge of ACA & Medicare Advantage risk adjustment methodology, coding guidelines (ICD-10-CM), healthcare compliance, and… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …for the execution and day-to-day management of data submissions for ACA Commercial, Medicare , and Medicaid risk adjustment and quality programs. * Design ... and evaluating initiative impacts using the risk adjustment and quality analytics models across ACA Commercial, Medicare , and Medicaid. * Develop, lead,… more
- Blue KC (Kansas City, MO)
- …of that data. **Job Description** + Maintains expert knowledge of Medicare Advantage & ACA Risk Adjustment models + Responsible for all formal risk ... of the role + Minimum 5 years' experience in Medicare Advantage & ACA Risk Adjustment submission experience **Blue Cross and Blue Shield of Kansas City… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Medicare Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and ... integrity of key risk adjustment performance metrics through coordination of...and MS Access Database. + Experience with EDGE & ACA or Medicaid risk score methodology, including… more
- CareFirst (Baltimore, MD)
- …to ensure that all risk adjustment activities fully comply with Medicare , Medicaid, ACA , and state-specific regulations. Remain current on changes to ... **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Coding Operations Supervisor supports...supports the execution of the corporate coding strategy across Medicare Advantage, Medicaid, and ACA markets. This… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Risk Adjustment Manager plays a critical role in the development and execution of the corporate risk adjustment ... the end to end strategy by applying improvements and driving cost-effective risk adjustment actions across all organizational populations and products.… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Risk Adjustment Business Operations Analyst assumes a pro-active approach in ensuring the accuracy and ... integrity of key risk adjustment performance metrics through coordination of...and problem resolution to meet business operational requirements for Medicare Advantage(MA), Affordable Care Act ( ACA ) &… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …your knowledge of risk adjustment and healthcare data (primarily Medicare Advantage, Medicaid, and ACA Commercial), looking for trends within data and ... enterprise. The ideal candidate will have experience with risk adjustment , Medicare Advantage, Medicaid, ACA commercial, clinical coding, SQL, Power BI… more
- Blue KC (Kansas City, MO)
- …experience + Strong knowledge of Medicare Advantage and Qualified Health Plans ( ACA ) including Stars and Risk Adjustment + Experience in consulting ... programs focused on improving the quality of care for Medicare Advantage & Qualified Health Plan ( ACA )...and monitor provider metrics to identify risk adjustment , HEDIS or educational opportunities for the Medicare… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …providing needed data and reporting, and partner with actuaries to resolve related risk adjustment issues. The ideal candidate will have experience with ... Encounter Data, Medicare Advantage, Medicaid, ACA commercial, and clinical...BI, and will have experience partnering with actuaries on risk adjustment issues. Your Responsibilities * Performs… more
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