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 ...
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 ...
Lewes, DE · Remote
$134K - $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
Lewes, DE · Remote
$134K - $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 ...
Wilmington, DE · On-site +1
$115K - $135K/yr
... high risk medication use, and make appropriate evidence-based recommendations to patients and ... Familiarity with Medicare, HEDIS, and STAR ratings Physical Requirements: * Prolonged periods of ...
Wilmington, DE · On-site +1
$115K - $135K/yr
... high risk medication use, and make appropriate evidence-based recommendations to patients and ... Familiarity with Medicare, HEDIS, and STAR ratings Physical Requirements: * Prolonged periods of ...
Wilmington, DE · Remote
$115K - $135K/yr
... high risk medication use, and make appropriate evidence-based recommendations to patients and ... Familiarity with Medicare, HEDIS, and STAR ratings Physical Requirements: * Prolonged periods of ...
Wilmington, DE · Remote
$115K - $135K/yr
... high risk medication use, and make appropriate evidence-based recommendations to patients and ... Familiarity with Medicare, HEDIS, and STAR ratings Physical Requirements: * Prolonged periods of ...
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 ...
Wilmington, DE · On-site +1
$68K - $109K/yr
Articulate the net revenue impact of RCA calculations and adjustments to finance leadership and other stakeholders, ensuring transparency and informed decision-making * Assist in preparing reports ...
Wilmington, DE · On-site +1
$68K - $109K/yr
Articulate the net revenue impact of RCA calculations and adjustments to finance leadership and other stakeholders, ensuring transparency and informed decision-making * Assist in preparing reports ...
Dover, DE · On-site +1
$52K - $70K/yr
Some positions at Novogradac may be open to remote or hybrid work arrangements depending on ... adjustments as needed. * Ability to work collaboratively in a team-oriented environment and ...
Dover, DE · On-site +1
$52K - $70K/yr
Some positions at Novogradac may be open to remote or hybrid work arrangements depending on ... adjustments as needed. * Ability to work collaboratively in a team-oriented environment and ...
| 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.

Full-time
Posted 5 days ago
Qualifications
Required: 2 Years Triage experience AND leadership experience.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