We have other current jobs related to this field that you can find below
-
Interim VP, Risk Adjustment
3 months ago
Pittsburgh, United States GSSR Inc Full timeJob DescriptionJob DescriptionProject Summary: Client is seeking a strategic leaderresponsible for ensuring the complete and accurate documentation of members'disease burden. This leader establishes and drives the health plan's strategyand organizational competency related to risk adjustment across all lines ofbusiness.Required Skills:8-11 years Risk...
-
VP, Credit Risk II
2 months ago
Pittsburgh, United States Dice Full timeCredit Risk II, Public Finance / Not-for-Profit Credit Risk We're seeking a future team member for the role of Vice President, Credit Risk II to join our Public Finance & Not-for-Profit Credit Risk team. This role can be located in Pittsburgh, PA; or Lake Mary, FL in a Hybrid work environment. About the team: At BNY Mellon, the Credit Risk group performs the...
-
HCC Coding Specialist/Risk Adjustment
19 hours ago
Pittsburgh, United States Murtech Staffing and Solutions Full time $25 - $30Job DescriptionJob DescriptionJob Title: HCC Coding Specialist/Risk Adjustment Coding Specialist – USC onlyLocation: 100% Remote Contract to hire Schedule: 7:00am-3:30pmEST or 8:00am-4:30pmESTJob SummaryThis job will deliver value to beneficiaries enrolled in Risk Adjusted government programs (MA and ACA), using skills including but not limited to: HCC...
-
Pittsburgh, United States Murtech Full timeJob DescriptionJob DescriptionJob Title: HCC Coding Specialist/Risk Adjustment Coding Specialist – USC onlyLocation: 100% RemoteSchedule: 7:00am-3:30pmEST or 8:00am-4:30pmEST Job Summary This job will deliver value to beneficiaries enrolled in Risk Adjusted government programs (MA and ACA), using skills including but not limited to: HCC Coding, medical...
-
VP, Credit Risk II
4 weeks ago
Pittsburgh, United States The Bank of New York Mellon Full timeCredit Risk II, Public Finance / Not-for-Profit Credit RiskBring your ideas. Make history. BNY Mellon offers an exciting array of future-forward careers at the intersection of business, finance, and technology. We are one of the world's top asset management and banking firms that manages trillions of dollars in assets, custody and/or administration. Known...
-
VP, Credit Risk II
1 week ago
Pittsburgh, United States BNY Full timeCredit Risk II, Public Finance / Not-for-Profit Credit Risk At BNY, our culture empowers you to grow and succeed. As a leading global financial services company at the center of the world’s financial system we touch nearly 20% of the world’s investible assets.Every day around the globe, our 50,000+ employees bring the power of their perspective to the...
-
VP, Credit Risk II – Public Finance
2 weeks ago
Pittsburgh, United States BNY Full timeCredit Risk II, Public Finance / Not-for-Profit Credit Risk At BNY, our culture empowers you to grow and succeed. As a leading global financial services company at the center of the world’s financial system we touch nearly 20% of the world’s investible assets. Every day around the globe, our 50,000+ employees bring the power of their perspective to the...
-
VP, Credit Risk II – Public Finance
2 weeks ago
Pittsburgh, United States BNY Full timeCredit Risk II, Public Finance / Not-for-Profit Credit Risk At BNY, our culture empowers you to grow and succeed. As a leading global financial services company at the center of the world’s financial system we touch nearly 20% of the world’s investible assets. Every day around the globe, our 50,000+ employees bring the power of their perspective to the...
-
VP, Credit Risk II
1 week ago
Pittsburgh, United States BNY Full timeCredit Risk II, Public Finance / Not-for-Profit Credit Risk At BNY, our culture empowers you to grow and succeed. As a leading global financial services company at the center of the world's financial system we touch nearly 20% of the world's investible assets. Every day around the globe, our 50,000+ employees bring the power of their perspective to the table...
-
VP, Credit Risk II
2 weeks ago
Pittsburgh, United States BNY Full timeCredit Risk II, Public Finance / Not-for-Profit Credit Risk At BNY, our culture empowers you to grow and succeed. As a leading global financial services company at the center of the world's financial system we touch nearly 20% of the world's investible assets. Every day around the globe, our 50,000+ employees bring the power of their perspective to the table...
-
VP, Credit Risk II – Public Finance
2 weeks ago
Pittsburgh, United States BNY Full timeCredit Risk II, Public Finance / Not-for-Profit Credit Risk At BNY, our culture empowers you to grow and succeed. As a leading global financial services company at the center of the world’s financial system we touch nearly 20% of the world’s investible assets. Every day around the globe, our 50,000+ employees bring the power of their perspective to the...
-
VP, Credit Risk II – Public Finance
16 hours ago
Pittsburgh, United States BNY Full timeCredit Risk II, Public Finance / Not-for-Profit Credit Risk At BNY, our culture empowers you to grow and succeed. As a leading global financial services company at the center of the world’s financial system we touch nearly 20% of the world’s investible assets. Every day around the globe, our 50,000+ employees bring the power of their perspective to the...
-
VP, Credit Risk II
2 weeks ago
Pittsburgh, United States BNY Full timeCredit Risk II, Public Finance / Not-for-Profit Credit Risk At BNY, our culture empowers you to grow and succeed. As a leading global financial services company at the center of the world's financial system we touch nearly 20% of the world's investible assets. Every day around the globe, our 50,000+ employees bring the power of their perspective to the table...
-
VP, Credit Risk II
5 days ago
Pittsburgh, PA, United States BNY Full timeCredit Risk II, Public Finance / Not-for-Profit Credit Risk At BNY, our culture empowers you to grow and succeed. As a leading global financial services company at the center of the world’s financial system we touch nearly 20% of the world’s investible assets. Every day around the globe, our 50,000+ employees bring the power of their perspective to...
-
VP, Credit Risk II
2 weeks ago
Pittsburgh, PA, United States BNY Full timeCredit Risk II, Public Finance / Not-for-Profit Credit Risk At BNY, our culture empowers you to grow and succeed. As a leading global financial services company at the center of the world's financial system we touch nearly 20% of the world's investible assets. Every day around the globe, our 50,000+ employees bring the power of their perspective to the table...
-
VP, Credit Risk II – Public Finance
2 weeks ago
UNITED STATES, PA, PITTSBURGH BNY Full timeCredit Risk II, Public Finance / Not-for-Profit Credit Risk At BNY, our culture empowers you to grow and succeed. As a leading global financial services company at the center of the world’s financial system we touch nearly 20% of the world’s investible assets. Every day around the globe, our 50,000+ employees bring the power of their perspective to the...
-
Back-End Developer
3 months ago
Pittsburgh, United States The Bank of New York Mellon Full timeBack-End Developer, VP Bring your ideas. Make history. BNY Mellon offers an exciting array of future-forward careers at the intersection of business, finance, and technology. We are one of the world's top asset management and banking firms that manages trillions of dollars in assets, custody and/or administration. Known as the "bank of banks" - 97% of the...
-
VP, Insurance Product Strategy, Design
3 months ago
Pittsburgh, Pennsylvania, United States Highmark Health Full timeCompany :Highmark Inc.Job Description : JOB SUMMARYThe VP of Insurance Product Strategy, Design, & Implementation will oversee product strategy, innovation, portfolio management and the development of necessary implementation roadmaps, and product performance evaluation, across Federal Markets, ACA/individual, DSNP, small group, large regional, and national...
-
VP Corporate Financial Planning Analysis
3 months ago
Pittsburgh, Pennsylvania, United States Arconic Full timeArconic is looking for a VP, Financial Planning & Analysis for our Corporate team. This position supports the Chief Financial Officer on financial planning, forecasting, reporting and all other financial requirements necessary to support our business. This is a highly visible position in the succession pipeline for top finance leadership positions in both...
-
VP Corporate Financial Planning Analysis
3 months ago
Pittsburgh, United States Arconic Full timeArconic is looking for a VP, Financial Planning & Analysis for our Corporate team. This position supports the Chief Financial Officer on financial planning, forecasting, reporting and all other financial requirements necessary to support our business. This is a highly visible position in the succession pipeline for top finance leadership positions in both...
![GSSR](https://media.trabajo.org/img/noimg.jpg)
Interim VP, Risk Adjustment
3 months ago
Job Description
Job Description
Project Summary:
Client is seeking a strategic leaderresponsible for ensuring the complete and accurate documentation of members'disease burden. This leader establishes and drives the health plan's strategyand organizational competency related to risk adjustment across all lines ofbusiness.
Required Skills:
8-11 years Risk Adjustment in Health Plan environment, focus on Medicare Advantage, however, experience in other LOBs (Medicaid, Exchange, and Commercial)
Oversees health plans risk adjustment program for all lines of business (Medicare, Medicaid, Exchange, Commercial), including development and execution of the risk adjustment strategy. Focus on Medicare Advantage business.
Collaborates with stakeholders across the organization (including market leaders, Chief Actuary, Chief Financial Officer, Medical Directors, Quality, Care Management, Information Technology, Product Development, and Provider Network Management) to achieve enterprise goals.
Responsibilities:
Designs, develops, and implements risk adjustment strategies and tactics including both prospective efforts to drive risk score completeness and accuracy, as well as retrospective strategies.
Evaluates program performance against targets for risk score accuracy and tightly manages vendor performance to ensure program integrity. Develops and monitors management reports that measure expected service levels, data and processing quality, and production volumes of risk adjustment initiatives and programs and operations. Identifies and addresses process improvement opportunities.
Establishes a risk based approach for developing initiatives designed to mitigate RADV risk and ensure risk score accuracy. Ensures compliance with administrative and legal requirements concerning risk adjustment data submissions and processes.
Engages with key provider groups on risk adjustment initiatives and provides risk adjustment data and reporting to support value based contracts.
Monitors CMS and MDHHS systems, guidance and notices, and oversees the implementation of new Medicare Advantage, Medicaid, and ACA risk adjustment requirements consistent with CMS and MDHHS regulations.
Recruits, develops and motivates a high performing team, and provides career and skill development for the team. Motivates and inspires the team and others involved in the risk adjustment initiative to commit to ever increasing standards of excellence, service, results orientation, and quality.
#J-18808-Ljbffr