The RADV Nurse will enhance consistency and efficiency by collaborating with Providers to meet goals for Hierarchical Condition Categories (HCC) Ratio. Spearhead initiatives for Risk Adjustment ...
The RADV Nurse will enhance consistency and efficiency by collaborating with Providers to meet goals for Hierarchical Condition Categories (HCC) Ratio. Spearhead initiatives for Risk Adjustment ...
RADV (Risk Adjustment Validation) Nurse- Quality Management
San Antonio, TX ยท On-site
$36.50 - $53/hr
The RADV Nurse will enhance consistency and efficiency by collaborating with Providers to meet goals for Hierarchical Condition Categories (HCC) Ratio. Spearhead initiatives for Risk Adjustment ...
RADV (Risk Adjustment Validation) Nurse- Quality Management
San Antonio, TX ยท On-site
$36.50 - $53/hr
The RADV Nurse will enhance consistency and efficiency by collaborating with Providers to meet goals for Hierarchical Condition Categories (HCC) Ratio. Spearhead initiatives for Risk Adjustment ...
RADV (Risk Adjustment Validation) Nurse- Quality Management
San Antonio, TX ยท On-site
$36.50 - $53/hr
The RADV Nurse will enhance consistency and efficiency by collaborating with Providers to meet goals for Hierarchical Condition Categories (HCC) Ratio. Spearhead initiatives for Risk Adjustment ...
RADV (Risk Adjustment Validation) Nurse- Quality Management
San Antonio, TX ยท On-site
$36.50 - $53/hr
The RADV Nurse will enhance consistency and efficiency by collaborating with Providers to meet goals for Hierarchical Condition Categories (HCC) Ratio. Spearhead initiatives for Risk Adjustment ...
Plan, manage, and provide oversight for RADV audits, including data analysis to identify required medical records, vendor oversight, project management, and submission of medical records, supporting ...
Plan, manage, and provide oversight for RADV audits, including data analysis to identify required medical records, vendor oversight, project management, and submission of medical records, supporting ...
POSITION SUMMARY/RESPONSIBILITIES The Risk Adjustment Data Validation (RADV) Auditor is responsible for auditing medical records to validate ICD-10-CM coding accuracy and ensure compliance with ...
POSITION SUMMARY/RESPONSIBILITIES The Risk Adjustment Data Validation (RADV) Auditor is responsible for auditing medical records to validate ICD-10-CM coding accuracy and ensure compliance with ...
POSITION SUMMARY/RESPONSIBILITIES The Risk Adjustment Data Validation (RADV) Auditor is responsible for auditing medical records to validate ICD-10-CM coding accuracy and ensure compliance with ...
POSITION SUMMARY/RESPONSIBILITIES The Risk Adjustment Data Validation (RADV) Auditor is responsible for auditing medical records to validate ICD-10-CM coding accuracy and ensure compliance with ...
Auditor, Risk Adjustment Data Validation
San Antonio, TX ยท Remote
$22.10 - $38.25/hr
POSITION SUMMARY/RESPONSIBILITIES The Risk Adjustment Data Validation (RADV) Auditor is responsible for auditing medical records to validate ICD-10-CM coding accuracy and ensure compliance with ...
Auditor, Risk Adjustment Data Validation
San Antonio, TX ยท Remote
$22.10 - $38.25/hr
POSITION SUMMARY/RESPONSIBILITIES The Risk Adjustment Data Validation (RADV) Auditor is responsible for auditing medical records to validate ICD-10-CM coding accuracy and ensure compliance with ...
Risk Adjustment Coding Auditor
Albany, NY ยท Remote
$30 - $35/hr
We are seeking a Risk Adjustment Coding Auditor with 8+ years of experience to support first- and second-pass audits for CMS RADV (Risk Adjustment Data Validation) projects. The ideal candidate must ...
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Risk Adjustment Coding Auditor
Albany, NY ยท Remote
$30 - $35/hr
We are seeking a Risk Adjustment Coding Auditor with 8+ years of experience to support first- and second-pass audits for CMS RADV (Risk Adjustment Data Validation) projects. The ideal candidate must ...
Auditor, Risk Adjustment Data Validation
San Antonio, TX ยท On-site
$22.10 - $38.25/hr
POSITION SUMMARY/RESPONSIBILITIES The Risk Adjustment Data Validation (RADV) Auditor is responsible for auditing medical records to validate ICD-10-CM coding accuracy and ensure compliance with ...
Auditor, Risk Adjustment Data Validation
San Antonio, TX ยท On-site
$22.10 - $38.25/hr
POSITION SUMMARY/RESPONSIBILITIES The Risk Adjustment Data Validation (RADV) Auditor is responsible for auditing medical records to validate ICD-10-CM coding accuracy and ensure compliance with ...
Auditor, Risk Adjustment Data Validation
San Antonio, TX ยท On-site
$22.10 - $38.25/hr
POSITION SUMMARY/RESPONSIBILITIES The Risk Adjustment Data Validation (RADV) Auditor is responsible for auditing medical records to validate ICD-10-CM coding accuracy and ensure compliance with ...
Auditor, Risk Adjustment Data Validation
San Antonio, TX ยท On-site
$22.10 - $38.25/hr
POSITION SUMMARY/RESPONSIBILITIES The Risk Adjustment Data Validation (RADV) Auditor is responsible for auditing medical records to validate ICD-10-CM coding accuracy and ensure compliance with ...
Auditor, Risk Adjustment Data Validation
San Antonio, TX ยท Remote
$22.10 - $38.25/hr
POSITION SUMMARY/RESPONSIBILITIES The Risk Adjustment Data Validation (RADV) Auditor is responsible for auditing medical records to validate ICD-10-CM coding accuracy and ensure compliance with ...
Auditor, Risk Adjustment Data Validation
San Antonio, TX ยท Remote
$22.10 - $38.25/hr
POSITION SUMMARY/RESPONSIBILITIES The Risk Adjustment Data Validation (RADV) Auditor is responsible for auditing medical records to validate ICD-10-CM coding accuracy and ensure compliance with ...
Risk Adjustment & RADV * Serve as operational lead for Risk Adjustment program activities and vendor coordination. * Manage RA Vendor platform administration, project configuration, user access, and ...
Risk Adjustment & RADV * Serve as operational lead for Risk Adjustment program activities and vendor coordination. * Manage RA Vendor platform administration, project configuration, user access, and ...
Manager, Risk Adjustment
Worcester, MA ยท On-site
$90K/yr
Lead RADV audit readiness and response, including medical record retrieval, validation, submission strategy, and cross-functional coordination with Legal, Compliance, and Finance to mitigate ...
Manager, Risk Adjustment
Worcester, MA ยท On-site
$90K/yr
Lead RADV audit readiness and response, including medical record retrieval, validation, submission strategy, and cross-functional coordination with Legal, Compliance, and Finance to mitigate ...
Manager, Risk Adjustment
Worcester, MA ยท On-site
Lead RADV audit readiness and response, including medical record retrieval, validation, submission strategy, and cross-functional coordination with Legal, Compliance, and Finance to mitigate ...
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Manager, Risk Adjustment
Worcester, MA ยท On-site
Lead RADV audit readiness and response, including medical record retrieval, validation, submission strategy, and cross-functional coordination with Legal, Compliance, and Finance to mitigate ...
Lead RADV audit readiness and response, including medical record retrieval, validation, submission strategy, and cross-functional coordination with Legal, Compliance, and Finance to mitigate ...
Lead RADV audit readiness and response, including medical record retrieval, validation, submission strategy, and cross-functional coordination with Legal, Compliance, and Finance to mitigate ...
Senior Manager, Risk Adjustment
Pasadena, CA ยท On-site
$100K - $150K/yr
This role plays a key part in aligning cross-functional teams, driving RADV audit readiness, and informing enterprise-level decisions related to financial forecasting, coding accuracy, and population ...
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Senior Manager, Risk Adjustment
Pasadena, CA ยท On-site
$100K - $150K/yr
This role plays a key part in aligning cross-functional teams, driving RADV audit readiness, and informing enterprise-level decisions related to financial forecasting, coding accuracy, and population ...
Risk Adjustment Coding Auditor
Prosper, TX ยท On-site
$25 - $28.50/hr
This role will be occupied by a certified risk adjustment coder to support first and second pass auditing for CMS RADV's. Required skillset: MS Suite CPC certified CRC certified 5+ years of risk ...
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Risk Adjustment Coding Auditor
Prosper, TX ยท On-site
$25 - $28.50/hr
This role will be occupied by a certified risk adjustment coder to support first and second pass auditing for CMS RADV's. Required skillset: MS Suite CPC certified CRC certified 5+ years of risk ...
Business Analyst with Risk Adjustment (Payor) || 1099 only || Need USC or GC only
Atlanta, GA ยท On-site
Participate in audit support (e.g., RADV, IVA) and validation of risk adjustment data submissions. * Act as liaison between technical teams and business stakeholders to ensure delivery of actionable ...
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Business Analyst with Risk Adjustment (Payor) || 1099 only || Need USC or GC only
Atlanta, GA ยท On-site
Participate in audit support (e.g., RADV, IVA) and validation of risk adjustment data submissions. * Act as liaison between technical teams and business stakeholders to ensure delivery of actionable ...
Drawing on deep expertise in Medicare Advantage risk adjustment, RADV compliance, and encounter data integrity, this role drives continuous improvement of internal controls, proactively surfaces ...
Drawing on deep expertise in Medicare Advantage risk adjustment, RADV compliance, and encounter data integrity, this role drives continuous improvement of internal controls, proactively surfaces ...
VP, Internal Audit
Orange, CA ยท On-site
Drawing on deep expertise in Medicare Advantage risk adjustment, RADV compliance, and encounter data integrity, this role drives continuous improvement of internal controls, proactively surfaces ...
VP, Internal Audit
Orange, CA ยท On-site
Drawing on deep expertise in Medicare Advantage risk adjustment, RADV compliance, and encounter data integrity, this role drives continuous improvement of internal controls, proactively surfaces ...
Radv information
What is the difference between Radv vs Radiologic Technologist?
| Aspect | Radv | Radiologic Technologist |
|---|---|---|
| Credentials | Certification in radiography, often specific to radiology | Certification in radiography or radiologic technology |
| Work Environment | Hospitals, clinics, imaging centers | Hospitals, outpatient clinics, diagnostic labs |
| Employer & Industry Usage | Primarily in radiology departments | Broader healthcare settings including radiology |
Radv and Radiologic Technologist roles share similar credentials and work environments, often overlapping in hospitals and clinics. However, Radv may focus more specifically on radiology procedures, while Radiologic Technologists have a broader scope including various imaging techniques. Both are essential in diagnostic healthcare, with Radv often specializing in radiography.
What are the key skills and qualifications needed to thrive as a Radiologic Technologist, and why are they important?
What are Radv?
What are some common challenges faced by Radiologic Technologists (Rad Techs) and how can they be managed on the job?

RADV (Risk Adjustment Validation) Nurse- Quality Management
San Antonio, TX โข On-site
Full-time
Posted 15 days ago
Job description
POSITION SUMMARY/RESPONSIBILITIES
Manages, supervises, and assists Sr. Manager Clinical Process Improvement of Quality Management and Accreditation with oversight assigned staff to facilitate high-quality, cost-effective care for Community First membership. The RADV Nurse will enhance consistency and efficiency by collaborating with Providers to meet goals for Hierarchical Condition Categories (HCC) Ratio. Spearhead initiatives for Risk Adjustment improvement, develop recommendations for Risk Adjustment plans, and design tools and databases to gather relevant data for assigned provider groups. Works closely with various departmental teams and their leaders in a matrix structure. Additionally, the RADV Nurse will provide direction and support to provider Medical Coding Analysts and Community First cross-functional team members regarding Risk Adjustment issues. Creates customized reports based on analysis of data for dissemination and makes recommendations to improve the quality of operational/clinical performance and health outcomes. Provides ongoing management of data collection systems and the development of procedures for monitoring, validating, and reconciling data for accuracy. May serve as a leader/facilitator of process improvement efforts. Provides oversight of and performs functions of review, investigation and analysis of member level clinical care data and provider performance as it compares to standards of care.
EDUCATION/EXPERIENCE
Graduation from an accredited school of professional nursing is required.ย Bachelor's degree in nursing, clinical informatics, or other health care related field is preferred. Over five years of experience in the healthcare industry, including at least one year of ICD-10 coding. Familiarity with CMS HCC Model and Guidelines, as well as ICD-10 Guidelines, is essential. Experience in data analysis and preparation of QI or related reports is preferred. Excellent communication and interpersonal skills required.ย Quality Management certification such as CPHQ or CHCQM is preferred.ย Working knowledge of continuous process improvement principles and standard coding products is preferred.ย Proficiency in health information systems, electronic health records (EHRs), HEDIS, RADV, and claims data analysis is a plus.
LICENSURE/CERTIFICATION
- Current licensure as a Registered Nurse in the State of Texas is required.
- Coding certification within 2 years of employment (e.g., Certified Professional Coder - CPC, Certified Coding Specialist - CCS)