Risk adjustment jobs in Newark, New Jersey (NJ) State

Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. Newark, NJ - Hybrid time typeFull time posted onPosted 30+ Days Ago job requisition id2019...

Horizon Blue Cross Blue Shield of New Jersey is an Equal Opportunity/Affirmative Action employer. Newark, NJ - Hybrid time typeFull time posted onPosted 15 Days Ago job requisition id2019-3051 **Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or ...

... pharmacies. * Coordinates transition of member from RAM RN to care management RN based ... or pharmacy visits. * Assesses member's clinical need against established guidelines and/or ...

Horizon BCBSNJ employees must live in New Jersey, New York, Pennsylvania, Connecticut or Delaware. This range has been created in good faith based on information known to Horizon at the time of posting. Horizon also provides a comprehensive compensation and benefits package which includes:. Horiz...

The Data Analyst leads the technology process for the end-to-end Risk Adjustment Processing System (RAPS) and Encounter Data Processing System (EDPS) data flow and works within key regulator guidelines for acceptable data submission. As the senior analyst of data, will be responsible for leading ...

The Risk Adjustment Data Analyst III is a seasoned analyst responsible for playing an active role in submission, monitoring and contributing to the end-to-end Risk Adjustment Data Submission and Validation within key regulator guidelines for acceptable data submission. The analyst will also be re...

The Senior Professional Coder provides services to perform code abstraction using the Official Coding Guidelines for ICD-9-CM/ICD-10-CM, AHA Coding Clinic Guidance, and in accordance with all state regulations, federal regulations, internal policies, and internal procedures.HCC Risk Adjustment Co...

Thorough understanding of healthcare risk adjustment coding practices and principles. ...

Bring your experience with healthcare analytics experience to an established insurer and play an active role in submission, monitoring, and contributing to the end-to-end Risk Adjustment Data Submission and Validation. You will be responsible for oversight and participation in projects including ...

As the Senior Manager, Technology Change Risk Oversight you will play a key role in the review, risk identification, risk assessment, reporting, and effective challenge of technology processes, controls, and capabilities, including but not limited to material and high risk technology changes. The...

Job Overview:The Manager will be responsible for working closely with assigned areas and team members to facilitate incident review, promote patient safety and support regulatory and risk compliance. Represent the Risk Management Department on hospital committees as needed, including the provisio...

As the Senior Manager, Technology Change Risk Oversight you will play a key role in the review, risk identification, risk assessment, reporting, and effective challenge of technology processes, controls, and capabilities, including but not limited to material and high risk technology changes. The...

Center 3 (19075), United States of America, McLean, VirginiaSenior Manager, Technical Program Management - Enterprise DataAre you interested in leading programs that deliver on critical business goals and build large scale products & platforms?About Capital One: At Capital One, we’re changing ban...

Manager, Process Management - Enterprise Services RiskRisk Managers at Capital One are highly motivated risk and process management professionals with excellent analytical, organizational, risk management, project management, and communication skills. A successful Risk Manager operates from a fou...

Center 3 (19075), United States of America, McLean, VirginiaSenior Manager, Technical Program Management - Enterprise DataAre you interested in leading programs that deliver on critical business goals and build large scale products & platforms?About Capital One: At Capital One, we’re changing ban...

Center 1 (19052), United States of America, McLean, VirginiaSenior Manager, Technical Program Management (Card Data Tech)Are you interested in leading programs that deliver on critical business goals and build large scale products & platforms?About Capital One: At Capital One, we’re changing bank...

Have a solid understanding of operational risk frameworks to create meaningful categorization of risk, risk ratings, loss estimates, prevention tools and risk management strategies. Based on modeled results for potential losses, create mitigating procedures and controls that take into account org...

Work with business to identify application related requirements for Veeva RIM development. ...

Would you like to bring your knowledge and experience along with your interpersonal and organizational skills to be a main contributor to the growth and expansion of our team and company in the NJ/NY Metro area? We are seeking a dedicated and committed HR Administrative Assistant to join our Team...

One of our clients, a Healthcare organization, is looking for a Data Analyst. ...

The Risk Business Analyst/Project Manager will be responsible for providing wide ranging and high-quality Business Analyst and Project Management services to the Firm and the global Risk Management organization, across all areas of Risk Management: measuring, quantifying, analyzing, reporting, co...

Good Experience in SDLC & Requirement Authoring along with Veeva (Regulatory) skills.Proficiency in Jira story and agile is mandatory.Resource is expected to play a role of BA with following duties :.Create Quality Assurance Plan & Requirement Specs.Create Epic, Stories and Qualification Criteria...

Proven experience as a Technical Project Manager with a focus on Infrastructure or Software Development projects. We are seeking an experienced Technical Project Manager with a strong background in Infrastructure or Software Development. Utilize project management tools and methodologies to track...

We are seeking a detail-oriented and experienced Medical Biller to join our client’s team. The Medical Biller will be responsible for managing all aspects of the billing process for their physical therapy practice, including claim submission, reimbursement tracking, and addressing billing inquiri...