- Northeast Georgia Health System, Inc (Gainesville, GA)
- …of 5+ years experience with increasing responsibilities in developing and executing risk coding programs.Knowledge of, and experience with, utilizing EPIC ... Excel, PowerPoint and Word). Essential Tasks and ResponsibilitiesShall develop a comprehensive risk coding accuracy program and curriculum in dyad with matrix… more
- Cambia Health Solutions, Inc (Portland, OR)
- …Key Experience: Risk Adjustment Experience (MUST HAVE) Risk Coding - CRC Certification (MUST HAVE) Network Contracts experienceValue Based ... risk adjustment experience includingMinimum 4 years of experience in a HCC Coding Audit or Network Management roleEquivalent combination of education and… more
- Somatus (Mclean, VA)
- …establish risk adjustment analytics such as predictive modeling for coding improvement opportunities, provider coding improvement opportunities, provider ... for risk adjustment optimization, particularly for provider and member engagement activities. + Manage processes needed to conduct at home wellness visits.… more
- Capital One (Mclean, VA)
- Center 1 (19052), United States of America, McLean, Virginia Audit Manager, Cyber Risk & Analysis - Technology Audit (Hybrid) **Capital One's Audit function is a ... including critical technology functions, cloud-based infrastructure, emerging technology, cybersecurity, risk management, application, and third-party management, as well as… more
- Capital One (Mclean, VA)
- …security, network security, cyber security, data protection), information systems risk management, information systems auditing, or a combination + At least 1 ... Center 1 (19052), United States of America, McLean, Virginia Principal Auditor Cyber Risk & Analysis, Technology Audit (Hybrid) Capital One's Audit function is a… more
- LA Care Health Plan (Los Angeles, CA)
- Provider Network Account Manager III Job Category: Provider Relations Department: Provider Network Management Location: Los Angeles, CA, US, 90017 Position Type: ... to support the safety net required to achieve that purpose. Job Summary The Provider Network Account Manager III is responsible for all aspects of the LA Care (LAC)… more
- University of Washington (Seattle, WA)
- …prioritize efforts to help achieve increased efficiency, reduced costs, mitigation of risk , and increased network reliability and sustainability. Work with ... over a dozen clinics across the state); the Washington State K20 Education Network (connecting ~400 school districts); the Pacific Northwest Gigapop - the regional… more
- Centene Corporation (Harrisburg, PA)
- …Acts as a liaison between Tier II providers (large PCP groups not on risk contracts and providers with upside only incentives) and the health plan. Manages ... Network performance for assigned territory through a consultative/account management...approach. Drives provider performance improvement in the following areas: Risk /P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost and utilization,… more
- Centene Corporation (Columbia, SC)
- …between Tier III and Tier IV providers (small to medium PCP groups not on risk contracts and providers with upside only incentives) and the health plan. Manages ... Network performance for assigned territory through a consultative/account management...approach. Drives provider performance improvement in the following areas: Risk /P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost and utilization,… more
- Centene Corporation (Madison, WI)
- …and/or those with complex contracts) and the health plan. Manages Network performance for assigned territory through a consultative/account management approach. ... Drives provider performance improvement in the following areas: Risk /P4Q, Health Benefit Ratio (HBR), HEDIS/quality, cost and utilization, etc. Evaluates provider… more
