- CVS Health (New Albany, OH)
- …personal, convenient and affordable. Aetna has an exciting opportunity for a Program Manager to join our Risk Adjustment Retrospective Program for ... project manager and subject matter expert in Risk Adjustment chart retrieval & coding programs...+ Strong written and verbal communication. **Preferred Qualifications** + Risk adjustment program experience within… more
- Molina Healthcare (Owensboro, KY)
- **JOB DESCRIPTION** **Job Summary** Responsible for retrospective risk adjustment programs involving department or cross-functional teams of subject matter ... Owners of supporting IT systems. **Job Duties** + Oversee all retrospective risk adjustment programming and provide insightful reporting on trends,… more
- Sutter Health (Sacramento, CA)
- … program management in a healthcare or health plan setting. + Knowledge of risk adjustment program management. + Knowledge of health plan regulatory and ... **Organization:** Sutter Health Plan - Valley **Position Overview:** As a program management expert, the incumbent will develop, manage, and execute regulatory and… more
- VNS Health (Manhattan, NY)
- …our mission to optimize clinical coding practices and enhance the efficacy of our Risk Adjustment Program . Your role involves leading initiatives to ... OverviewAs the Clinical Manager for Risk Adjustment ,...creating policies, procedures, and workflows to drive a successful Risk Adjustment program required +… more
- The Cigna Group (Nashville, TN)
- …activities for the Cigna Compliance Department, with particular emphasis on Coding, Risk Adjustment and Coding Decisions. Collaborates with Cigna Compliance ... excel in a dynamic, fast-paced environment. The candidate must demonstrate solid command of risk adjustment . This compliance team member must be adept at working… more
- Fallon Health (Worcester, MA)
- …have shared ownership within the Analytics staff for product line(s) as assigned by the Risk Adjustment Operations and Analytics Manager and will be a SME ... of government-sponsored health insurance programs-including Medicare, Medicaid, and PACE ( Program of All-Inclusive Care for the Elderly)- in the...Summary of Purpose** : The primary role of the Risk Adjustment Analyst (RAA) will be to… more
- Elevance Health (Norfolk, VA)
- …data analysis, reporting and formulating recommendations and providing guidance to further the risk adjustment program for Group Retiree Services. **How you ... ** Risk Adjustment Strategy Consultant** **Location:** This...Strategy. Unless specified as primarily virtual by the hiring manager , associates are required to work at an Elevance… more
- Fallon Health (Worcester, MA)
- …feedback and submit to Manager for provider education efforts + Update risk adjustment software with all relevant chart review observations + Meet or ... and report on FCHP patient charts for the purpose of validating regulatory Risk Adjustment scores. The Chart Review Specialist will collect diagnostic details… more
- HSBC (New York, NY)
- …all relevant risk areas eg credit risk , counterparty credit risk , securitization, and Credit Valuation Adjustment ('CVA'). GRPA currently maintains a ... establishment of interpretations and governance processes to mitigate regulatory risk . GRPA also monitors new rule developments and other...City area may be considered. As our Regulatory Policy Manager - Credit Valuation Adjustment you will:… more
- Blue Cross Blue Shield of Massachusetts (Hingham, MA)
- …to ensure coding and clinical documentation accuracy and consistency. Collaborating with the Manager of Risk Adjustment Operations, this position will also ... This position is eligible for the Flex persona The Risk Adjustment Senior Coding Quality Auditor &...develop, evaluate and administer a Quality Review Program by auditing medical records reviewed by the coding… more