Medicare Risk Adjustment

Selected news for the healthcare topic - Medicare Risk Adjustment, collected since 4/2019. Recent stories appear in insurancejobs.com. This healthcare topic shares news with Anthem, Inc., UnitedHealth Group, UnitedHealth and many others.

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4/2/2021 Medicare Risk Adjustment Operations blogspot.com Medicare Risk Adjustment OperationsOn-Demand Course Overview:Medicare Advantage (MA) is one of the fastest-growing and most complex health plan lines of business representing significant growth opportunities for payers. Launching and/or managing a successful MA market requires careful, strategic planning to meet requirements, ensure compliance, and maximize the program benefits for your organization.Success in this market will depend on success in each of the following essential ...
1/9/2021 Medicare Risk Adjustment Operations blogspot.com ... quality care Managing utilizationThis course will touch on all four essential areas of MRA Operations.Learn more or Register hereReview the Agenda below:Risk Adjustment OperationsMedicare Risk Adjustment Overview History of Medicare Risk Adjustment Key Concepts and Terms Risk Adjustment Data Risk Adjustment Process Risk Adjustment Data ValidationCMS-HCC Risk ModelsPY 2020 CMS HCC Risk Adjustment Model PY 2021 CMS HCC Risk Adjustment Model PY ...
12/6/2020 Manager, Technical and Data Enablement - UnitedHealth Group - Eden Prairie, MN insurancejobs.com ... work. Clinical Performance (CP) is charged with effectively implementing, monitoring, and executing on clinical documentation, quality, and affordability programs that promote patient health while improving the provider practice experience with a special focus on Medicare Risk Adjustment and HEDIS. Clinical Performance processes on a national level by providing support in all markets served by OptumCare Delivery.This position will report into the Director of Risk Adjustment Submissions and will be overall ...
12/4/2020 Manager, Design and Implementation - UnitedHealth Group - Eden Prairie, MN insurancejobs.com ... sm) Clinical Performance (CP) is charged with effectively implementing, monitoring, and executing on clinical documentation, quality, and affordability programs that promote patient health while improving the provider practice experience with a special focus on Medicare Risk Adjustment and HEDIS. Clinical Performance processes on a national level by providing support in all markets served by OptumCare Delivery. This position will report into the Director of Risk Adjustment Submissions and will be ...
12/1/2020 Clinical Performance, Market Relations Regional Program Manager - Pacific and\/or Mountain TimezoneTelecommute - UnitedHealth Group - Eden Prairie, MN insurancejobs.com ... sm) Clinical Performance (CP) is charged with effectively implementing, monitoring, and executing on clinical documentation, quality, and affordability programs that promote patient health while improving the provider practice experience with a special focus on Medicare Risk Adjustment and HEDIS. Clinical Performance processes on a national level by providing support in all markets served by OptumCare Delivery. This position will report into the Market Relations Regional Associate Director. This position is ...
11/24/2020 Sr Business Analyst, Portal Solutions San Antonio, TX - UnitedHealth Group - San Antonio, TX insurancejobs.com ... providing analysis skills, monitoring organizational performance to plan, identifying factors to determine and recommend areas of business development and enhancement, and developing clear action plans to drive processes. Responsible to learn and understand the Medicare Risk Adjustment business and the company strategy to achieve optimal care for our members. Primary Responsibilities: Responsible to complete thorough business analyses, which includes examining business processes and workflows for optimization and / or performing statistical ...
11/20/2020 Senior Manager, Chart Review Data Analytics - Telecommute - UnitedHealth Group - Eden Prairie, MN insurancejobs.com ... sm) Clinical Performance (CP) is charged with effectively implementing, monitoring, and executing on clinical documentation, quality, and affordability programs that promote patient health while improving the provider practice experience with a special focus on Medicare Risk Adjustment and HEDIS. Clinical Performance processes on a national level by providing support in all markets served by OptumCare Delivery. This position will report into the Director - Chart Review and will be overall responsible ...
11/20/2020 Medicare Risk Adjustment and Coding Consultant - Telecommute - UnitedHealth Group - Eden Prairie, MN insurancejobs.com Medicare Risk Adjustment and Coding Consultant - Telecommute Medicare Risk Adjustment and Coding Consultant - Telecommute UnitedHealth Group Eden Prairie, Minnesota, United States 22 hours ago Apply NowDescription Combine two of the fastest-growing fields on the planet with a culture of performance, collaboration and opportunity and this is what you get. Leading edge technology in an industry that's improving the lives of millions. Here, innovation isn't about another gadget, it's ...
8/13/2020 Data Analyst, Clinical Performance - Telecommute - UnitedHealth Group - Eden Prairie, MN insurancejobs.com ... sm) Enterprise Clinical Performance (ECP) is charged with effectively implementing, monitoring, and executing on clinical documentation and quality programs that promote patient health while improving the provider practice experience with a special focus on Medicare Risk Adjustment and HEDIS. ECP processes on a national level by providing support in all markets served by OptumCare Delivery & OptumCare Services. This position will report into the Enterprise Clinical Performance Associate Director- Business Process ...
8/3/2020 Medicare Consultant, Practice Performance Manager Hybrid - Field Based in Indiana - UnitedHealth Group - Indianapolis, IN insurancejobs.com ... payment methodology and the importance of proper chart documentation of procedures and diagnosis coding Monitors Stars quality performance data for providers and promotes improved healthcare outcomes Utilizes analytics and identifies and target providers for Medicare Risk Adjustment training and documentation/coding resources Assist providers in understanding the Medical Condition Assessment Incentive Program and Medicare Stars quality and CMS - HCC Risk Adjustment driven payment methodology and the importance of proper chart ...
7/9/2020 Medicare Risk Adjustment and Coding Consultant - Field Based in Arizona - UnitedHealth Group - Flagstaff, AZ insurancejobs.com ... in understanding the CMS-HC Risk Adjustment program as it relates to payment methodology and the importance of proper chart documentation of procedures and diagnosis coding Utilizes analytics and identifies and target providers for Medicare Risk Adjustment training and documentation/coding resources Assist providers in understanding the Medical Condition Assessment Incentive Program and Medicare Stars quality and CMS - HCC Risk Adjustment driven payment methodology and the importance of proper chart ...
7/1/2020 Solving the Challenge of High-volume Health Plan Chart Requests healthcareittoday.com The following is a guest article by Steve Mallinak, Senior Vice President of Operations at Ciox . Every year, healthcare providers receive thousands of health plan chart requests. From Medicare Risk Adjustment (MRA) requests to HEDIS requests, Affordable Care Act (ACA) records retrieval, RADV, DRG Audit, CIP and QIP: the alphabet soup of chart request types is long, and providers have to fill every request. The health plans’ demand for records ...
6/30/2020 NY hospitals receive $1.1B in safety-net funding Crain's New York Business ... of the drug are expected to be paid by governments and insurers, not patients. MEDICARE RISK ADJUSTMENT: Moorestown, N.J.–based Tabula Rasa HealthCare said Monday that it has launched an online education series for Medicare risk adjustment. The program is designed for physicians, nurses and other clinicians who offer services in value-based care settings, the health-tech company said. That includes programs of all-inclusive care for the elderly ...
6/29/2020 Tabula Rasa HealthCare’s Risk Adjustment Division Launches New Online Training for Physicians and Other Providers Globe Newswire ... MOORESTOWN, N.J., June 29, 2020 (GLOBE NEWSWIRE) -- Tabula Rasa HealthCare ® (TRHC) (NASDAQ: TRHC ), a healthcare technology company advancing the field of medication safety, has launched the “Clinical Documentation Excellence” (CDE) Online Education series for Medicare risk adjustment. The program is designed for physicians, physician assistants, nurse practitioners, and other clinicians who offer services in value-based care settings, including Programs of All-inclusive Care for the Elderly (PACE), Medicare Advantage ...
6/29/2020 Tabula Rasa HealthCare’s Risk Adjustment Division Launches New Online Training for Physicians ... biomedreports.com ... MOORESTOWN, N.J., June 29, 2020 (GLOBE NEWSWIRE) -- Tabula Rasa HealthCare ® (TRHC) (NASDAQ:TRHC), a healthcare technology company advancing the field of medication safety, has launched the “Clinical Documentation Excellence” (CDE) Online Education series for Medicare risk adjustment. The program is designed for physicians, physician assistants, nurse practitioners, and other clinicians who offer services in value-based care settings, including Programs of All-inclusive Care for the Elderly (PACE), Medicare Advantage ...
6/29/2020 Tabula Rasa HealthCare’s Risk Adjustment Division Launches New Online Training for Physicians and Other Providers tabularasahealthcare.com ... Other Providers Moorestown, NJ, June 29, 2020 — Tabula Rasa HealthCare ®(TRHC) (NASDAQ:TRHC) , a healthcare technology company advancing the field of medication safety, has launched the “Clinical Documentation Excellence” (CDE) Online Education series for Medicare risk adjustment. The program is designed for physicians, physician assistants, nurse practitioners, and other clinicians who offer services in value-based care settings, including Programs of All-inclusive Care for the Elderly (PACE), Medicare Advantage ...
6/29/2020 Tabula Rasa HealthCare’s Risk Adjustment Division Launches New Online Training for Physicians and Other Providers gurufocus.com ... Value-based Care Clinicians MOORESTOWN, N.J., Tabula Rasa HealthCare ® ( NASDAQ:TRHC ) ( NASDAQ:TRHC ), a healthcare technology company advancing the field of medication safety, has launched the “Clinical Documentation Excellence” (CDE) Online Education series for Medicare risk adjustment. The program is designed for physicians, physician assistants, nurse practitioners, and other clinicians who offer services in value-based care settings, including Programs of All-inclusive Care for the Elderly (PACE), Medicare Advantage ...
6/18/2020 Medicare Risk Adjustment Fraud is Not Victimless constantinecannon.com ... enrolled in an MA plan—involves just a technical record-keeping or administrative dispute with CMS and no actual victims. Risk Adjustment Fraud Has Victims Nothing could be farther from the truth. In fact, Medicare risk adjustment fraud does involve victims. They include: (1) millions of Medicare patients who fail to receive proper medical care because their healthcare providers are more focused on what diagnosis codes they must enter to ...
6/17/2020 Medicare Consultant - Field based in Lubbock or Amarillo, TX and surrounding area - UnitedHealth Group - Lubbock, TX insurancejobs.com ... and diagnoses coding. Understand Medicare Stars quality program utilizing analytics and identifies and targeted providers Monitor Stars quality performance data for providers and promotes improved healthcare outcomes Utilizes analytics and identifies targeted providers for Medicare Risk Adjustment training and documentation/coding resources Assist providers in understanding the MCAIP incentive program, Medicare Stars quality and CMS -HCC Risk Adjustment driven payment methodology with importance of proper chart documentation of procedures and ...
4/15/2020 4 Ways MSOs Can Help ACOs Succeed with Medicare Risk Adjustment apixio.com Blog 4.15.20 4 Ways MSOs Can Help ACOs Succeed with Medicare Risk Adjustment Risk adjustment is a complex but vital competency accountable care organizations (ACOs) must develop in order to succeed in CMS’s (MSSP) . Without capturing a complete, accurate picture of member risk during the reporting year, ACOs risk jeopardizing their care management effectiveness. However, many ACOs don’t have the internal expertise to implement a successful risk adjustment program. Healthcare ...