Familiarity with HCC coding, risk adjustment, STAR ratings, and HEDIS quality measures * Background ... and remote monitoring * Collaborate with physicians, RNs, social workers, therapists, caregivers ...
Quick apply
Familiarity with HCC coding, risk adjustment, STAR ratings, and HEDIS quality measures * Background ... and remote monitoring * Collaborate with physicians, RNs, social workers, therapists, caregivers ...
Nurse Practitioner
Lewes, DE · Remote
$135K/yr
This is a remote position. We're Hiring: Nurse Practitioner Delaware | Remote | Full-Time The Role ... risk adjustment, and closure of STAR and HEDIS quality gaps * Help develop and refine care pathways ...
Quick apply
Nurse Practitioner
Lewes, DE · Remote
$135K/yr
This is a remote position. We're Hiring: Nurse Practitioner Delaware | Remote | Full-Time The Role ... risk adjustment, and closure of STAR and HEDIS quality gaps * Help develop and refine care pathways ...
Overview This is a full-time career opportunity that can be remote or hybrid. The role is ... Evaluate pricing effectiveness and recommend adjustments based on market conditions, interest rate ...
Overview This is a full-time career opportunity that can be remote or hybrid. The role is ... Evaluate pricing effectiveness and recommend adjustments based on market conditions, interest rate ...
Overview This is a full-time career opportunity that can be remote or hybrid. This role is ... Risk Management & Controls Establish and maintain operational controls that safeguard revenue ...
Overview This is a full-time career opportunity that can be remote or hybrid. This role is ... Risk Management & Controls Establish and maintain operational controls that safeguard revenue ...
Senior SOC Analyst - 2nd Shift Weekends
Middletown, DE · Remote
$62.50 - $64.90/hr
The ability to balance security principles with business realities as part of a risk-managed ... LI-MP1LI-REMOTE
Senior SOC Analyst - 2nd Shift Weekends
Middletown, DE · Remote
$62.50 - $64.90/hr
The ability to balance security principles with business realities as part of a risk-managed ... LI-MP1LI-REMOTE
Senior SOC Analyst - 2nd Shift Weekends
Dover, DE · Remote
$62.50 - $64.90/hr
The ability to balance security principles with business realities as part of a risk-managed ... LI-MP1LI-REMOTE
Senior SOC Analyst - 2nd Shift Weekends
Dover, DE · Remote
$62.50 - $64.90/hr
The ability to balance security principles with business realities as part of a risk-managed ... LI-MP1LI-REMOTE
Senior SOC Analyst - 2nd Shift Weekends
Seaford, DE · Remote
$62.50 - $64.90/hr
The ability to balance security principles with business realities as part of a risk-managed ... LI-MP1LI-REMOTE
Senior SOC Analyst - 2nd Shift Weekends
Seaford, DE · Remote
$62.50 - $64.90/hr
The ability to balance security principles with business realities as part of a risk-managed ... LI-MP1LI-REMOTE
Senior SOC Analyst - 2nd Shift Weekends
Smyrna, DE · Remote
$62.50 - $64.90/hr
The ability to balance security principles with business realities as part of a risk-managed ... LI-MP1LI-REMOTE
Senior SOC Analyst - 2nd Shift Weekends
Smyrna, DE · Remote
$62.50 - $64.90/hr
The ability to balance security principles with business realities as part of a risk-managed ... LI-MP1LI-REMOTE
Senior SOC Analyst - 2nd Shift Weekends
Newark, DE · Remote
$62.50 - $64.90/hr
The ability to balance security principles with business realities as part of a risk-managed ... LI-MP1LI-REMOTE
Senior SOC Analyst - 2nd Shift Weekends
Newark, DE · Remote
$62.50 - $64.90/hr
The ability to balance security principles with business realities as part of a risk-managed ... LI-MP1LI-REMOTE
Senior SOC Analyst - 2nd Shift Weekends
Wilmington, DE · Remote
$62.50 - $64.90/hr
The ability to balance security principles with business realities as part of a risk-managed ... LI-MP1LI-REMOTE
Senior SOC Analyst - 2nd Shift Weekends
Wilmington, DE · Remote
$62.50 - $64.90/hr
The ability to balance security principles with business realities as part of a risk-managed ... LI-MP1LI-REMOTE
Senior SOC Analyst - 2nd Shift Weekends
Milford, DE · Remote
$62.50 - $64.90/hr
The ability to balance security principles with business realities as part of a risk-managed ... LI-MP1LI-REMOTE
Senior SOC Analyst - 2nd Shift Weekends
Milford, DE · Remote
$62.50 - $64.90/hr
The ability to balance security principles with business realities as part of a risk-managed ... LI-MP1LI-REMOTE
Remote Medicare Risk Adjustment information
What is the difference between Remote Medicare Risk Adjustment vs Remote Medical Coding Specialist?
| Aspect | Remote Medicare Risk Adjustment | Remote Medical Coding Specialist |
|---|---|---|
| Certifications | CPR, CPC, or RAC certifications often preferred | CPC, CCS, or CCS-P certifications |
| Work Environment | Healthcare insurance companies, Medicare plans | Hospitals, clinics, insurance companies |
| Industry Usage | Primarily in Medicare risk adjustment programs | Medical billing and coding across various healthcare settings |
Remote Medicare Risk Adjustment and Remote Medical Coding Specialist roles share certifications and healthcare industry usage but differ in focus. Medicare Risk Adjustment involves analyzing patient data to optimize Medicare plan reimbursements, while Medical Coding Specialists translate medical records into billing codes. Both roles require healthcare knowledge but serve distinct functions within the healthcare revenue cycle.
What are popular job titles related to Remote Medicare Risk Adjustment jobs in Delaware?
For Remote Medicare Risk Adjustment jobs in Delaware, the most frequently searched job titles are:
What job categories do people searching Remote Medicare Risk Adjustment jobs in Delaware look for?
The top searched job categories for Remote Medicare Risk Adjustment jobs in Delaware are:
What cities in Delaware are hiring for Remote Medicare Risk Adjustment jobs?
Cities in Delaware with the most Remote Medicare Risk Adjustment job openings:
Full-time
Posted 27 days ago
Job description
Qualifications
Required: 2 Years Triage experience AND leadership experience.- Master's degree or higher in Nursing or a related clinical field
- 2+ years of experience in any of the following:
- Telemedicine Care
- Care Management
- Active clinical licensure — any of the following:
- Nurse Practitioner (NP) – Delaware (DE)
- Family Nurse Practitioner (FNP) – Delaware (DE)
- OR any of the following nationally recognized NP certifications:
- Family Nurse Practitioner (FNP)
- Nurse Practitioner (NP)
- Gerontological Nurse Practitioner (GNP)
- 1+ years of Medicaid or Dual Eligible (D‑SNP) populations
- Experience working in interdisciplinary care teams
- Familiarity with HCC coding, risk adjustment, STAR ratings, and HEDIS quality measures
- Background in home‑based care, transitional care, or chronic disease management
Join our client's innovative healthcare team to deliver virtual, physician‑led care for medically complex Medicaid and Dual Eligible patients across Delaware. This role offers flexibility, autonomy, and the opportunity to help launch a new market focused on proactive, home‑based care that improves patient outcomes and reduces avoidable hospitalizations.
Key Responsibilities- Provide comprehensive care management for medically complex Medicaid and D‑SNP patients through telehealth and remote monitoring
- Collaborate with physicians, RNs, social workers, therapists, caregivers, PCPs, managed care organizations, and community partners
- Guide patients and caregivers through care transitions, including hospital‑to‑home coordination and advance care planning
- Support quality initiatives through accurate clinical documentation, including HCC coding, risk adjustment, and closure of STAR/HEDIS gaps
- Contribute to the development of care pathways, workflows, and best practices as the Delaware program expands
- Build strong, trusting relationships with patients, families, caregivers, and interdisciplinary team members
- Participate in a shared 24/7 clinical triage rotation to prevent avoidable emergency department visits and hospitalizations