preferred. At least 2 years of leadership or supervisory experience. Experience with Medicare Advantage risk adjustment..., documentation, coding, and Health Risk Assessments for high-risk or chronically ill populations. Demonstrated clinical expertise...
preferred. At least 2 years of leadership or supervisory experience. Experience with Medicare Advantage risk adjustment..., documentation, coding, and Health Risk Assessments for high-risk or chronically ill populations. Demonstrated clinical expertise...
more: . Position Summary: The Senior Manager, Technical Lead / Solution Architect combines strategic solution design with hands..., integrates enterprise platforms (e.g., Veeva Vault PromoMats and Adobe Experience Manager), and incubates Generative...
customer issues to achieve customer satisfaction? About This Business LexisNexis Risk Solutions is the essential partner... in the assessment of risk for businesses. We offer a multitude of solutions focused on helping businesses of all sizes drive...
customer issues to achieve customer satisfaction? About This Business LexisNexis Risk Solutions is the essential partner... in the assessment of risk for businesses. We offer a multitude of solutions focused on helping businesses of all sizes drive...
and Management (E/M) inpatient and outpatient coding experience Must reside in CA Profee ONLY NOT HCC/risk adjustment, ASC... year or more) Under the direction of the Coding Compliance Manager, the Specialty Physician Coder plays a key role...
compliance Strong communication and collaboration skills with providers and teams ProFee coding only (no HCC/risk adjustment... and education to providers and clinical partners Collaborate with Coding Compliance Manager to identify trends, irregularities...
(ProFee) coding only (no HCC/risk adjustment, ASC, or facility coding) Must reside in California Nice-to-Have Skills... and clinical partners Collaborate with the Coding Compliance Manager on coding trends, irregularities, and corrective actions...
About the role This role is on our Worldrisk line of business and assists the underwriters by screening risk... traditional UA duties, this role will: Support regional UA Manager in overseeing all daily business activities and act as the...
Risk Adjustment team processing all medical record requests in a timely and efficient manner ensuring accuracy... manner ensuring the correct medical record is obtained and valid for risk adjustment review purposes. Validates requests...
in CDI processes Familiarity with risk adjustment concepts and processes Understanding of Patient Safety Indicators (PSI... and assist the Manager with personnel-related duties. In this role, you will organize, direct, coordinate, and manage the...
measures, and risk adjustment initiatives. Present payer and performance scorecards to review benchmarks, identify gaps... for HEDIS/STAR and risk adjustment benchmarks. Analyze practice-level data and scorecards to identify trends, gaps...
), Certified Professional Medical Auditor (CPMA), Certified Risk Adjustment Coder (CRC) by AAPC, or Certified Coding Specialist... productivity report to HIM manager by defined deadline. Meets and maintains HIM coding quality and productivity standards. Attends...
launch. Stay ahead of regulatory and payer trends (CMS rules, MA and risk adjustment, value-based care, interoperability... Intake, Capacity Logistics, Care Coordination, and Revenue Cycle Management (RCM). As the general manager and portfolio...
Senior AI Engineer, Business Solutions ClearBridge Investments is a leading global equity manager with over $180... to internal builds, quantify TCO, lock in risk, compliance posture, and speed to value. Present recommendations and rollout plans...
-based care or risk-adjustment models is a plus. Exceptional attention to detail, problem-solving abilities, and the... Support and Maintenance: Serve as the primary manager of the Power BI revenue model(s) that calculate revenue and gross...
on Medicare Advantage (Part C) and Prescription Drug (Part D) programs. In this vital role, you will conduct Risk Adjustment Data... Validation (RADV) audits, compliance risk-based audits, support external audit coordination, and ensure alignment with CMS...
assignment and sequencing of risk adjustment diagnoses following established guidelines. Reviews work queues to identify charts... billing/abstracting systems using established professional and regulatory coding guidelines. Ensures that each diagnosis...
are required, and experience with risk adjustment is highly valued. Epic Clarity Data Model certification in one or more modules—such as EpicCare... Schedule: Monday to Friday, 8 AM – 5 PM (Pacific Time). Interview Process: 2-step process (1 Zoom interview with Manager and 1...
reimbursement, MS-DRG, APR-DRG, PSIs, HACs, POA, Vizient, Elixhauser, public profiling, and risk adjustment...Position Summary Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk...