- Somatus (Mclean, VA)
- …physical and mental well-being + Community engagement opportunities + And more! The Sr. Director , Medicare Risk Adjustment (MRA) will lead the execution ... experience required. + Proven experience with commercial and/ or Medicare Advantage risk adjustment functions. + Proven track record of working collaboratively… more
- The Cigna Group (Plano, TX)
- …TEXAS market - can live in Houston, San Antonio, Dallas or Plano** The ** Director , Provider Contracting - Medicare ** serves as an integral member of the ... Network Development and Strategy Team and reports to the Provider Contracting Senior Manager. This role is a key contributor to the development of the strategic… more
- The Cigna Group (Nashville, TN)
- …of the National Development and Network Solutions team, reporting directly to the Medicare National Partnerships Director . This role is a key contributor for ... and Medicare Advantage stakeholders for complex value-based and downside risk reimbursement methodologies for Medicare provider contracting matters. +… more
- Travelers Insurance Company (Honolulu, HI)
- …strategies for addressing and resolving various types of debt, including Medicare , to deliver positive financial outcomes. This role requires leveraging economic ... Support: + Partners with the Field, Claim Resources and Senior Leadership to identify and improve Claim processes and...a financial management and control strategy to limit financial risk associated with claim costs. + Serves as a… more
- Banner Health (Phoenix, AZ)
- …Health Services Organization (PHSO), will serve as the clinical DYAD to the Executive Director of Risk Adjustment, co-leading a robust team that will support the ... and develops clinical strategies and educational initiatives around the impact that accurate risk adjustment has on the performance of our MA, MSSP, Medicaid, and… more
- CenterWell (Carson City, NV)
- …of our caring community and help us put health first** The Associate Director , Risk Adjustment oversees quality assurance audits of medical records, ICD-10-CM, ... (CMS), other payers, and over government agencies. In addition, the Associate Director , Risk Adjustment oversees all medical coding education activities. The… more
- Prime Therapeutics (Providence, RI)
- …vision, depth perception and ability to adjust focus **Reporting Structure** + Reports to Senior Principal or Senior Director in the Finance department ... and drives every decision we make. **Job Posting Title** Principal Actuary - Medicare Part D - Remote **Job Description** The Principal Actuary is responsible for… more
- The Cigna Group (Atlanta, GA)
- …Relations, and Network Development & Solutions). Reporting to the Network Operations Senior Manager or Director , this individual ensures the effective ... network for his/her assigned sub-market and/or provider groups. The role of Senior Advisor with the Provider Performance Enablement team takes ownership for… more
- Martin's Point Health Care (Portland, ME)
- …Place to Work" since 2015. Position Summary Martin's Point Healthcare seeks a dynamic Director of IT Compliance, Audit, and Risk (CAR) to establish and drive ... Certification), and MBOI (Maine Bureau of Insurance) initiatives. The Director of IT CAR will report to the Chief...and will create partnerships with IT leadership, including the Senior Vice President of IT, Chief Information Security Officer… more
- HCA Healthcare (Nashville, TN)
- …Do you want to join an organization that invests in you as a Senior Director Regulatory and Accreditation? At HCA Healthcare, you come first. HCA ... make a difference. We are looking for a dedicated Senior Director Regulatory and Accreditation like you...and provides guidance to division vice president, quality or director , quality and risk management *Daily prioritization… more