PMP certification or equivalent training * Healthcare Insurance industry business and operational ... Furthermore, it is every employee's responsibility to comply with the company's Code of Business ...
PMP certification or equivalent training * Healthcare Insurance industry business and operational ... Furthermore, it is every employee's responsibility to comply with the company's Code of Business ...
Be Seen First
Director of Coding Compliance
Bronx, NY · On-site
$85K - $110K/yr
... from women's health to endocrinology and psychiatry. We also provide nursing home support, care ... Review ICD-10-CM, CPT, HCPCS, and risk adjustment coding to ensure alignment with CMS and payer ...
Quick apply
Be Seen First
Director of Coding Compliance
Bronx, NY · On-site
$85K - $110K/yr
... from women's health to endocrinology and psychiatry. We also provide nursing home support, care ... Review ICD-10-CM, CPT, HCPCS, and risk adjustment coding to ensure alignment with CMS and payer ...
Certified Professional Coder (CPC) Lead/Provider Liaison
$23.75 - $31.75/hr
... risk adjustment trends, provider coding performance and member health status using existing tools and performing ad hoc analysis Collaborates with the Network Management leadership in developing ...
Certified Professional Coder (CPC) Lead/Provider Liaison
$23.75 - $31.75/hr
... risk adjustment trends, provider coding performance and member health status using existing tools and performing ad hoc analysis Collaborates with the Network Management leadership in developing ...
Program Manager - Risk Adjustment
New York, NY · On-site +1
Monitor and evaluate the progress, alignment and financial "health" of a cross-functional group of ... Furthermore, it is every employee's responsibility to comply with the company's Code of Business ...
Program Manager - Risk Adjustment
New York, NY · On-site +1
Monitor and evaluate the progress, alignment and financial "health" of a cross-functional group of ... Furthermore, it is every employee's responsibility to comply with the company's Code of Business ...
You will need to obtain access and retrieve records from a variety of digital platforms, including ... Use Health Information Technology (HIT) standards to identify proper chart types and valid ...
You will need to obtain access and retrieve records from a variety of digital platforms, including ... Use Health Information Technology (HIT) standards to identify proper chart types and valid ...
Risk Adjustment Medical Record Retrieval Specialist
Manhattan, NY · Remote
$72K - $82K/yr
You will need to obtain access and retrieve records from a variety of digital platforms, including ... Use Health Information Technology (HIT) standards to identify proper chart types and valid ...
Risk Adjustment Medical Record Retrieval Specialist
Manhattan, NY · Remote
$72K - $82K/yr
You will need to obtain access and retrieve records from a variety of digital platforms, including ... Use Health Information Technology (HIT) standards to identify proper chart types and valid ...
Certified Professional Coder (CPC) Lead/Provider Liaison
Newark, NJ · On-site
$23.75 - $31.50/hr
... risk adjustment trends, provider coding performance and member health status using existing tools and performing ad hoc analysis Collaborates with the Network Management leadership in developing ...
New
Certified Professional Coder (CPC) Lead/Provider Liaison
Newark, NJ · On-site
$23.75 - $31.50/hr
... risk adjustment trends, provider coding performance and member health status using existing tools and performing ad hoc analysis Collaborates with the Network Management leadership in developing ...
New
Risk Adjustment Medical Record Retrieval Specialist
Manhattan, NY · On-site
$72K - $82K/yr
You will need to obtain access and retrieve records from a variety of digital platforms, including ... Use Health Information Technology (HIT) standards to identify proper chart types and valid ...
Risk Adjustment Medical Record Retrieval Specialist
Manhattan, NY · On-site
$72K - $82K/yr
You will need to obtain access and retrieve records from a variety of digital platforms, including ... Use Health Information Technology (HIT) standards to identify proper chart types and valid ...
Director of Coding Compliance
Bronx, NY · On-site
... from women's health to endocrinology and psychiatry. We also provide nursing home support, care ... Review ICD-10-CM, CPT, HCPCS, and risk adjustment coding to ensure alignment with CMS and payer ...
Director of Coding Compliance
Bronx, NY · On-site
... from women's health to endocrinology and psychiatry. We also provide nursing home support, care ... Review ICD-10-CM, CPT, HCPCS, and risk adjustment coding to ensure alignment with CMS and payer ...
Director of Coding Compliance
Bronx, NY · On-site
$85K - $110K/yr
... from women's health to endocrinology and psychiatry. We also provide nursing home support, care ... Review ICD-10-CM, CPT, HCPCS, and risk adjustment coding to ensure alignment with CMS and payer ...
Director of Coding Compliance
Bronx, NY · On-site
$85K - $110K/yr
... from women's health to endocrinology and psychiatry. We also provide nursing home support, care ... Review ICD-10-CM, CPT, HCPCS, and risk adjustment coding to ensure alignment with CMS and payer ...
... from women's health to endocrinology and psychiatry. We also provide nursing home support, care ... Review ICD-10-CM, CPT, HCPCS, and risk adjustment coding to ensure alignment with CMS and payer ...
... from women's health to endocrinology and psychiatry. We also provide nursing home support, care ... Review ICD-10-CM, CPT, HCPCS, and risk adjustment coding to ensure alignment with CMS and payer ...
Director of Coding Compliance
Bronx, NY · On-site
... from women's health to endocrinology and psychiatry. We also provide nursing home support, care ... Review ICD-10-CM, CPT, HCPCS, and risk adjustment coding to ensure alignment with CMS and payer ...
Director of Coding Compliance
Bronx, NY · On-site
... from women's health to endocrinology and psychiatry. We also provide nursing home support, care ... Review ICD-10-CM, CPT, HCPCS, and risk adjustment coding to ensure alignment with CMS and payer ...
Director of Coding Compliance
Bronx, NY · On-site
$85K - $110K/yr
... from women's health to endocrinology and psychiatry. We also provide nursing home support, care ... Review ICD-10-CM, CPT, HCPCS, and risk adjustment coding to ensure alignment with CMS and payer ...
Director of Coding Compliance
Bronx, NY · On-site
$85K - $110K/yr
... from women's health to endocrinology and psychiatry. We also provide nursing home support, care ... Review ICD-10-CM, CPT, HCPCS, and risk adjustment coding to ensure alignment with CMS and payer ...
Hybrid Coding Educator
Manhattan, NY · On-site
$30 - $34.25/hr
Responsible for auditing clinical documentation encounters to validate Risk Adjustment and HCCs ... Demonstrates up-to-date knowledge of healthcare regulatory, coding mandates and OIG work plan.
Hybrid Coding Educator
Manhattan, NY · On-site
$30 - $34.25/hr
Responsible for auditing clinical documentation encounters to validate Risk Adjustment and HCCs ... Demonstrates up-to-date knowledge of healthcare regulatory, coding mandates and OIG work plan.
Hybrid Coding Educator
$29.75 - $34/hr
Responsible for auditing clinical documentation encounters to validate Risk Adjustment and HCCs ... Demonstrates up-to-date knowledge of healthcare regulatory, coding mandates and OIG work plan.
Hybrid Coding Educator
$29.75 - $34/hr
Responsible for auditing clinical documentation encounters to validate Risk Adjustment and HCCs ... Demonstrates up-to-date knowledge of healthcare regulatory, coding mandates and OIG work plan.
Data Analyst - Remote
New York, NY · On-site +1
... and at home. Experience the fulfillment of advancing the health of your community with the ... for a risk-bearing entities within Optum Health's East markets. This individual will leverage ...
New
Data Analyst - Remote
New York, NY · On-site +1
... and at home. Experience the fulfillment of advancing the health of your community with the ... for a risk-bearing entities within Optum Health's East markets. This individual will leverage ...
New
Hierarchical Condition Category (HCC) Coding Specialist
New York, NY · Remote
$41.85/hr
Supports all Remote Patient Monitoring (RPM) risk adjustment projects to comply with all CMS ... Registered Health Information Technician (RHIT) Preferred * None SKILLS * Critical Thinking
Hierarchical Condition Category (HCC) Coding Specialist
New York, NY · Remote
$41.85/hr
Supports all Remote Patient Monitoring (RPM) risk adjustment projects to comply with all CMS ... Registered Health Information Technician (RHIT) Preferred * None SKILLS * Critical Thinking
Hierarchical Condition Category (HCC) Coding Specialist
New York, NY · Remote
$41.85/hr
Supports all Remote Patient Monitoring (RPM) risk adjustment projects to comply with all CMS ... Registered Health Information Technician (RHIT) Preferred * None SKILLS * Critical Thinking
Hierarchical Condition Category (HCC) Coding Specialist
New York, NY · Remote
$41.85/hr
Supports all Remote Patient Monitoring (RPM) risk adjustment projects to comply with all CMS ... Registered Health Information Technician (RHIT) Preferred * None SKILLS * Critical Thinking
Cardiologist - Optum | , New York
Hicksville, NY · On-site
$359K - $406K/yr
... and at home. Experience the fulfillment of advancing the health of your community with the ... The regional alignment combines resources and services across the care continuum - from ...
New
Cardiologist - Optum | , New York
Hicksville, NY · On-site
$359K - $406K/yr
... and at home. Experience the fulfillment of advancing the health of your community with the ... The regional alignment combines resources and services across the care continuum - from ...
New
Cardiologist - Optum NY
Hicksville, NY · On-site
$359K - $406K/yr
... and at home. Experience the fulfillment of advancing the health of your community with the ... The regional alignment combines resources and services across the care continuum - from ...
New
Cardiologist - Optum NY
Hicksville, NY · On-site
$359K - $406K/yr
... and at home. Experience the fulfillment of advancing the health of your community with the ... The regional alignment combines resources and services across the care continuum - from ...
New
From Home Optum Health Coding Risk Adjustment information
What is the difference between From Home Optum Health Coding Risk Adjustment vs From Home Optum Health Medical Coding?
| Aspect | From Home Optum Health Coding Risk Adjustment | From Home Optum Health Medical Coding |
|---|---|---|
| Certifications | CCS, CPC, or RHIT/RHIA | CCS, CPC, or RHIT/RHIA |
| Work Environment | Remote, home-based | Remote, home-based |
| Industry Usage | Health insurance, risk adjustment programs | Healthcare providers, hospital coding |
| Job Focus | Risk adjustment coding for insurance accuracy | Clinical coding for medical records |
While both roles involve medical coding from home, From Home Optum Health Coding Risk Adjustment focuses on coding for insurance risk adjustment programs, requiring specific risk adjustment knowledge. In contrast, From Home Optum Health Medical Coding emphasizes clinical coding for medical records, often in hospital or provider settings. Both roles require similar certifications and offer remote work, but their primary focus and industry applications differ.
What are the most commonly searched types of Optum Health Coding Risk Adjustment jobs in New York?
The most popular types of Optum Health Coding Risk Adjustment jobs in New York are:
What are popular job titles related to From Home Optum Health Coding Risk Adjustment jobs in New York?
For From Home Optum Health Coding Risk Adjustment jobs in New York, the most frequently searched job titles are:
What job categories do people searching From Home Optum Health Coding Risk Adjustment jobs in New York look for?
The top searched job categories for From Home Optum Health Coding Risk Adjustment jobs in New York are:
What cities in New York are hiring for From Home Optum Health Coding Risk Adjustment jobs?
Cities in New York with the most From Home Optum Health Coding Risk Adjustment job openings:
Full-time
Posted 8 days ago
Highmark Health rating
7.8
Based on 28 frontline employees who took The Breakroom Quiz
Job description
JOB SUMMARY
The Senior Project Manager will be responsible for leading key projects directly engaging with our provider network around risk adjustment activities. This role demands a professional with excellent communication and interpersonal skills, capable of fostering strong relationships and leading productive discussions with provider groups and clinicians. A crucial aspect of this role involves the ability to identify when and how to effectively engage Highmark clinical teams to support and drive provider education initiatives. A critical eye for detail, superior organizational abilities, and advanced proficiency in Microsoft Excel and PowerPoint are essential for success. The ideal candidate thrives in a fast-paced environment, demonstrating strong decision-making skills, and brings a track record of successful project delivery. While not required, experience in risk adjustment programs (MA, ACA, and/or Medicaid) will be highly valued.
ESSENTIAL RESPONSIBILITIES
- Project Leadership & Management:
- Lead the planning, execution, and successful completion of key projects, particularly those involving direct engagement with provider networks.
- Manage project scope, timelines, and resources to ensure projects are delivered on time and within scope.
- Identify and proactively mitigate project risks, developing contingency plans as necessary.
- Develop and maintain comprehensive project documentation, including project plans, status reports, and stakeholder communications.
- Provider Engagement & Communication:
- Serve as the primary point of contact for provider groups, including clinicians.
- Facilitate and lead productive meetings and discussions with diverse provider stakeholders.
- Build and maintain strong, collaborative relationships with provider partners.
- Translate complex project information into clear and actionable communications for various audiences.
- Clinical Team Collaboration & Provider Education:
- Proactively collaborate with Highmark clinical teams to develop and deliver targeted provider education initiatives.
- Act as a liaison between project teams, providers, and Highmark clinical resources to ensure aligned efforts in education and support.
- Data Analysis & Reporting:
- Utilize advanced proficiency in Microsoft Excel to analyze project-related data, track performance, and identify trends.
- Prepare clear and compelling presentations using Microsoft PowerPoint to report project status, outcomes, and recommendations to stakeholders.
- Decision Making & Problem Solving:
- Demonstrate critical decision-making skills, especially in a fast-paced and dynamic project environment.
- Address project challenges and unforeseen issues effectively and efficiently, seeking optimal solutions.
EDUCATION
Required
- High School Diploma or equivalent
Substitutions
- None
Preferred
- Bachelor's degree
EXPERIENCE
Required
- 4 years of experience in a project manager role
Preferred
- PMP certification or equivalent training
- Healthcare Insurance industry business and operational knowledge
- Experience managing large, complex projects
- Very good leadership skills
- Very good organizational and planning skills
- Experience with an industry standard software development life-cycle
LICENSES AND CERTIFICATIONS
Required
- None
Preferred
- None
SKILLS
- Experience with customer relationship management
- Presentation skills
- Negotiation skills
- Experience with conflict resolution
- Experience with Risk Mitigation Planning
Language(Other than English)
None
Travel Requirement
0% - 25%
Position Type
Office-based or Remote
Teaches / trains others regularly
Occasionally
Travel regularly from the office to various work sites or from site-to-site
Occasionally
Works primarily out-of-the office selling products/services (sales employees)
Never
Physical work site required
Yes
Lifting: up to 10 pounds
Constantly
Lifting: 10 to 25 pounds
Occasionally
Lifting: 25 to 50 pounds
Occasionally
Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This position adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company's Handbook of Privacy Policies and Practices and Information Security Policy.
Furthermore, it is every employee's responsibility to comply with the company's Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Pay Range Minimum:
$86,400.00Pay Range Maximum:
$138,600.00Base pay is determined by a variety of factors including a candidate's qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations. The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.
We endeavor to make this site accessible to any and all users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below.
For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org
California Consumer Privacy Act Employees, Contractors, and Applicants Notice
What Highmark Health employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Highmark Health
Sourced by ZipRecruiter
A national blended health organization, Highmark Health and our leading businesses support millions of customers with products, services and solutions closely aligned to our mission of creating remarkable health experiences, freeing people to be their best. Headquartered in Pittsburgh, we're regionally focused in Pennsylvania, Delaware, West Virginia, and eastern and northwestern New York with customers in 50 states and the District of Columbia. We passionately serve individual consumers and fellow businesses alike. And our companies cover a diversified spectrum of essential health-related needs including health insurance, health care delivery, population health management, dental solutions, reinsurance solutions, and innovative, technology solutions. Our financial position reflects strength and stability, with our year-end 2022 consolidated revenues totaling $26 billion. And we're proud to carry forth an important legacy of compassionate care and philanthropy that began more than 170 years ago. This tradition of giving back, reinvesting and ensuring that our communities remain strong and healthy is deeply embedded in our culture, informing our decisions every day.
Industry
Health care and social assistance and insurance services
Company size
10,000+ Employees
Headquarters location
Pittsburgh, PA, US