fee proposals, which are modeled under a variety of assumptions including risk-sharing based on profitability... or a percentage of revenue associated with a program, when applicable. Collaborate with Network Services team leaders and clinical...
optimize their clinical, financial and operational results. Responsibilities: Develops summary and detail level dashboards..., maps, reports, analyses, MOR presentations, which represent clinical, operational or financial data that concisely...
experience. EXPERIENCE: 1. Operational experience in applicable business, clinical, payer or web application systems... strategic insights and improvements to business operations. 3. Experience working in inpatient and outpatient clinical...
Job Description: Summary: Under general supervision of Director Claims Management (Lifespan Risk Services..., Aviation, Environmental, Cyber Risk, Property, and Auto claims cases. Assists in development of answers to interrogatories...
of medical and clinical diagnoses, procedures, injuries, or illnesses into designated numerical codes. Hours: Monday – Friday...+ years of recent Medicare Risk Adjustment experience (HCC coding) with proficient knowledge of CMS-HCC model and guidelines...
of medical and clinical diagnoses, procedures, injuries, or illnesses into designated numerical codes. Hours: Monday – Friday...+ years of recent Medicare Risk Adjustment experience (HCC coding) with proficient knowledge of CMS-HCC model and guidelines...
available one-on-one or in groups. Health and Wellness Initiatives: Participate in walking challenges, weight loss programs, health risk assessments... and pioneering innovative clinical initiatives tailored to support doctors in supporting their patients' recovery and well-being...
total medical expenses (TME), utilization trends, risk adjustment data and cost drivers to help identify areas... and timely financial/utilization reporting, leveraging clinical data from EMR systems, claims data, and other sources. Provides...
, councils, PHS initiatives, or projects. Perform root cause analysis and/or risk assessments of adverse clinical events... with regulations, policies, procedures, and protocols to determine if documentation and practice meets current clinical standards...
meets current clinical standards of care. Document findings appropriately. *Research and stay up-to-date with current... in evaluating, writing, and revising clinical and non-clinical policies/procedures for PHH. *Collaborate with Education Department...
home into the healthcare hub. We coordinate care holistically across individuals' clinical, social, and behavioral needs so..., we're able to close critical care and social gaps, as well as manage risk for individuals who need help the most. This leads...
, councils, PHS initiatives, or projects. Perform root cause analysis and/or risk assessments of adverse clinical events... with regulations, policies, procedures, and protocols to determine if documentation and practice meets current clinical standards...
. in Bloomington, Indiana, is a state-of-the-art facility where we have an integrated model from process and formulation to clinical... to administrative controls after the cost/benefit and compliance risk are understood and addressed Completes all investigation...
. in Bloomington, Indiana, is a state-of-the-art facility where we have an integrated model from process and formulation to clinical... to administrative controls after the cost/benefit and compliance risk are understood and addressed Completes all investigation...
. in Bloomington, Indiana, is a state-of-the-art facility where we have an integrated model from process and formulation to clinical... to administrative controls after the cost/benefit and compliance risk are understood and addressed Completes all investigation...
. in Bloomington, Indiana, is a state-of-the-art facility where we have an integrated model from process and formulation to clinical... to administrative controls after the cost/benefit and compliance risk are understood and addressed Completes all investigation...
and support related to Memorial's business or clinical applications. Provides day-to-day management of applications for moderately... of current operational workflows that are supported through the business or clinical application.Participates in vendor selection...
in collaborative staffing(s) with psychologist, clinical staff, and supervisees Oversee quality implementation of Applied Behavioral..., such as an employer-sponsored health risk assessment and a Wellbeing mobile application, to assist employees on their wellbeing journey...
) Participates in collaborative staffing(s) with psychologist, clinical staff, and supervisees Oversee quality implementation..., such as an employer-sponsored health risk assessment and a Wellbeing mobile application, to assist employees on their wellbeing journey...
necessary in order to meet the needs of the Financial Services department and the clinical areas. Self-directed including the..., incumbents are not called upon to perform or assist in emergency care or first aid. The incumbent has no occupational risk...