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Ramboll US Corporation
Boston, MA, United States
Company DescriptionJob Description West Coast or East Coast, US West Coast locations: Portland, OR, Seattle, WA, or San Francisco/Oakland/Bay Area, Irvine, Los Angeles, CA East Coast locations: Princeton, NJ, Arlington, VA, or Boston, MA Are you eager to develop your excellence in an inclusive, collaborative, and empowering community? Are you exci
Job Source: Ramboll US CorporationRamboll Group A/S
Boston, MA, United States
West Coast locations: Portland, OR, Seattle, WA, or San Francisco/Oakland/Bay Area, Irvine, Los Angeles, CA East Coast locations: Princeton, NJ, Arlington, VA, or Boston, MA Are you eager to develop your excellence in an inclusive, collaborative, and empowering community? Are you excited about joining a company that strives to make a difference – f
Job Source: Ramboll Group A/SRamboll Group A/S
Boston, MA, United States
West Coast locations: Portland, OR, Seattle, WA, or San Francisco/Oakland/Bay Area, Irvine, Los Angeles, CA East Coast locations: Princeton, NJ, Arlington, VA, or Boston, MA Are you eager to develop your excellence in an inclusive, collaborative, and empowering community? Are you excited about joining a company that strives to make a difference – f
Job Source: Ramboll Group A/SBrigham & Women's Faulkner Hospital(BWFH)
Jamaica Plain, MA, United States
Reporting to the Senior Manager, Patient Safety and Risk Management, the Program Manager for Patient Safety will work with quality and safety leaders throughout Brigham & Women's Faulkner Hospital (BWFH) to provide program management, and analytical/decision-making support for BWFH safety initiatives. The Program Manager will provide comprehensive
Job Source: Brigham & Women's Faulkner Hospital(BWFH)M&T Bank
Boston, MA, United States
Overview: Manages assigned staff (on a direct and indirect basis) on multiple related projects and ongoing operations directed towards a common objective and affecting three or more businesses or functional areas. Manages changes to project scope, schedule and costs using appropriate verification techniques to keep the project plan accurate, upda
Job Source: M&T BankBrigham & Women's Faulkner Hospital(BWFH)
Boston, MA, United States
Reporting to the Senior Manager, Patient Safety and Risk Management, the Program Manager for Patient Safety will work with quality and safety leaders throughout Brigham & Women's Faulkner Hospital (BWFH) to provide program management, and analytical/decision-making support for BWFH safety initiatives. The Program Manager will provide comprehensive
Job Source: Brigham & Women's Faulkner Hospital(BWFH)Santander US
Boston
Director of IT Risk and Control Self Assessment (RCSA) Miami, United States of America The Director of IT Risk and Control Self Assessment (RCSA) within the Business Control & Risk Management function, operates within the first line of defense and is directly accountable to lead the Technology RCSA. The Director reports into the Senior Director of
Job Source: Santander USRockland Trust
Norwood, MA, United States
We offer options to work at our Plymouth and Norwood offices in a hybrid model or remotely. This position will report to the Operational Risk Officer and work closely with business units, IT, second line risk management and external contacts (e.g., third parties) as a thought leader in the maturation of the Third Party Risk Management Program, driv
Job Source: Rockland TrustBoston, MA, United States
The Risk Assessment Program Manager will help establish, develop, and maintain key operational initiatives to drive Clinical Documentation Program activities. This role will be responsible for the execution of Value Based campaigns, managing deadlines, working with providers and practices in execution of program activities. The Risk Assessment Program Manager is a valued thought leader, who will be responsible for facilitating and driving the definition and prioritization of complex risk adjustment improvement strategies.
The work you will do:
Establishes, develops, and implements Risk Adjustment activities across different Markets to ensure successful execution of Risk Adjustment programs while maintaining programs compliantly.
Creates & executes out of box thinking/creative way to execution of RA programs.
Ensures all activities are fully executed through end-to-end process from provider to Centers for Medicare and Medicaid Services (CMS), State and federal regulatory requirements.
Ensures early detection of major risks and interdependencies for program initiatives across the entire network.
Combines an in-depth knowledge of Risk Adjustment business, products, and services with a solid understanding of industry trends to develop differentiated solutions to maximize and grow partner relationships.
Works with stakeholders across the system to ensure effective coordination.
Provides updates to Risk Adjustment Stakeholders on program operational activities – creates dashboards and operational metrics to demonstrate program success.
Manages activity of cross-functional teams to help support reporting capabilities.
The skills and qualifications you need:
5+ years of experience with Risk Adjustment/HCC Payment Methodology
5+ years of experience working for a Health Plan/payor
3+ years of experience in project management
Bachelor’s degree in related field of study preferred.
Advanced Degree preferred or an equivalent combination of education and experience.
Demonstrates ability to expertly navigate a variety of software applications.
Solid knowledge and understanding of Payor, ACO, Medicare/Medicaid, End to End cycle for Risk Adjustment.
Ability to come in with an open mind, a starters mindset and able to navigate through ambiguity.
Must be a strategic thinker, with a high level of intellectual curiosity and openness to change.
Proven ability to perform complex business analysis and decision-making, with the ability to effectively analyze and synthesize large amounts of complex data in relevant insights.
Outstanding presentation and communication skills, ability to prepare and deliver presentations that convey critical information while being able to adjust, as necessary to meet the needs of the audience.
Excellent verbal and written skills, ability to interact well with both internal and external stakeholders.
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Email Alert for Risk Assessment Program Manager jobs in Boston, MA, United States
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