- CenterWell (Charleston, WV)
- **Become a part of our caring community and help us put health first** The Medicare Risk Adjustment Strategy Lead in the PCO risk adjustment area ... at increasing clinical efficiencies, processes, education, and compliance as it relates to Medicare Risk Adjustment . Uses data-based insight to direct… more
- UCLA Health (Los Angeles, CA)
- Description As the Medicare Advantage Risk Adjustment Performance Improvement Consultant, you will be responsible for: + Serving as a Subject Matter Expert ... (SME) for risk adjustment with contracted IPAs + Collaborating...Five or more years of experience in healthcare analytics, strategy , and/or consulting at an IPA or health plan… more
- Robert Half Accountemps (Long Beach, CA)
- …grievance and appeal management, and client service to drive successful integration with the Risk Adjustment strategy . The Director will work in close ... of the Medicare Star Ratings and Enterprise Risk Adjustment strategies that ensure our ...risk score accuracy and completeness in all enterprise risk adjustment activities. Development of strategy… more
- Highmark Health (Pittsburgh, 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
- Molina Healthcare (New York, NY)
- **Job Description** **Job Summary** The Director, Quality & Risk Adjustment is responsible for leading health plan execution for Risk and Quality ensuring ... of Quality Discipline including metrics and performance standards. Working knowledge of Risk Adjustment . + Project management experience, in a managed healthcare… more
- Datavant (Tallahassee, FL)
- …+ Knowledge and understanding of HCC mapping and models + Experience with coding Medicare , Commercial and Medicaid risk adjustment charts + Understanding of ... Medicare , Commercial and Medicaid risk adjustment business logic and coding +...other legally protected status. At Datavant our total rewards strategy powers a high-growth, high-performance, health technology company that… more
- Molina Healthcare (Miami, FL)
- …Plan provider engagement strategy to achieve positive quality and risk adjustment outcomes through effective provider engagement activities. Ensures the ... Plan have engagement plans to meet annual quality and risk adjustment goals. Drives coaching and collaboration...Min 3 years experience improving Quality performance for Medicaid, Medicare , and/or ACA Marketplace programs To all current Molina… more
- Datavant (Columbus, OH)
- …and managing in a remote environment (2+ years) + 3+ years of experience working with Medicare , ACA, and/or Medicaid risk adjustment models + 5+ years of ... vision for healthcare. **What we're looking for:** The incoming Risk Adjustment Analytics Manager will be stepping...with other managers and the department director to set strategy and mobilize the team to be as performant… more
- Marshfield Clinic (Marshfield, WI)
- …exciting missions in the world!** **Job Title:** Director of Actuarial and Risk Adjustment Services **Cost Center:** 682891378 SHP-Actuarial **Scheduled Weekly ... **Job Description:** **JOB SUMMARY** The Director of Actuarial & Risk Adjustment Services is a key leader...Chief Actuary to lead unit development and execution of strategy through tactics, actions, processes, plans, and analytical tools… more
- Centene Corporation (Queens, NY)
- …+ Develop and refine Medicare contract models to incorporate RAF ( Risk Adjustment Factor) trends, Stars quality metrics, and benchmarking methodologies to ... execution of the organization's Value-Based Payment strategies (VBP) and other risk -based contracting strategies. + Oversee Medicare -specific VBP contracts,… more