Email Alert for
ⓘ There was an unexpected error processing your request.
Please refresh the page and try again.
If the problem persists, please contact us with your issue.
You can always manage your preferences and update your interests to ensure you receive the most relevant opportunities.
Get ready to discover your next great opportunity.
CLevelCrossing
Bethesda, MD, United States
AVP MD Stars and Risk Adjustment Clinical Strategy and Leadership Location Bethesda, MD, United States Posted on Dec 17, 2022 Apply for this job your email: upload resume: Profile Job Information Humana AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership in Bethesda Maryland Description The Healthcare Quality Reporting & Improvem
Job Source: CLevelCrossingCLevelCrossing
Washington, DC, United States
Description Humana is a $77 billion (Fortune 41) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health and well-being of the people we serve, Humana is committed to advancing the employment experience and vitality of the associate community. Through offe
Job Source: CLevelCrossingCLevelCrossing
Bethesda, MD, United States
Description Humana is a $77 billion (Fortune 41) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health and well-being of the people we serve, Humana is committed to advancing the employment experience and vitality of the associate community. Through offe
Job Source: CLevelCrossingHumana Inc.
Bethesda, MD, United States
Associate VP Home Care Product Management Location Bethesda, MD, United States Employment Type Full-Time Posted on Oct 21, 2022 Apply for this job your email: upload resume: Profile Description Humana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. A
Job Source: Humana Inc.CLevelCrossing
Washington, DC, United States
Job Information Humana Associate VP, Quality Improvement in Washington District Of Columbia Description The AVP, Quality Improvement and Performance will develop, maintain, own and execute strategies to improve performance of the TRICARE contract and maintain performance under HGB's Clinical Quality Management Program. This individual is accountabl
Job Source: CLevelCrossingBrightSpring Health Services
Annandale, VA, United States
AVP, Business Development Job Locations US-MD-UPPER MARLBORO | US-MD-BALTIMORE | US-VA-ANNANDALE ID 2024-147192 Line of Business Revival Home Health & Hospice Position Type Full-Time Our Company Revival Home Care Agency Overview The Area Vice President (AVP) of Business Development is responsible for identifying and pursuing new busines
Job Source: BrightSpring Health ServicesCLevelCrossing
Bethesda, MD, United States
Associate VP Business Transformation and Clinical Innovation Location Bethesda, MD, United States Posted on Oct 21, 2021 Apply for this job your email: upload resume: Profile Job Information Humana Associate VP, Business Transformation and Clinical Innovation in Bethesda Maryland Description The AVP, Business Transformation and Clinical Innovati
Job Source: CLevelCrossingBlue Cross Blue Shield companies
Washington, DC, United States
The Executive Director supports strategic and operational leadership of the BCBSA Clinical Team, including support of the creation of the clinical operations strategy and delivery of value-added resources and tools. This role provides clinical expertise and population health thought leadership in support of delivering more affordable and quality ca
Job Source: Blue Cross Blue Shield companiesWashington, DC, United States
AVP MD Stars and Risk Adjustment Clinical Strategy and Leadership Location
Washington, DC, United States
Posted on
Dec 17, 2022
Apply for this job
your email:
upload resume:
Profile
Job Information
Humana
AVP, MD, Stars and Risk Adjustment Clinical Strategy and Leadership
in
Washington
District Of Columbia
Description
The Healthcare Quality Reporting & Improvement (HQRI) organization is seeking an AVP to lead its Provider Support team and associate's responsibilities. HQRI is an organization with over 900 associates that leads Humana'sStars and Risk Adjustment Strategy, operations, and performance nationally.
The Associate VP for Healthcare Quality Reporting and Improvement (HQRI) relies on medical background and industry-standard clinical / coding guidance to ensure physician and healthcare provider education, reporting and materials are accurate and consistent across the enterprise to support regional and corporate strategic initiatives.
Responsibilities
The AVP, MD, Stars and Risk Adjustment Clinical Strategy leads the HQRI Provider Support Team who work in collaboration with key corporate stakeholders and regional teams, to provide ongoing training, reporting, tools and programs to support corporate and regional strategies for physician and healthcare provider education for Risk Adjustment and Stars. In addition, the position provides supportive clinical and coding expertise across the teams in HQRI. This position reports to a Vice President in Healthcare Quality Reporting and Improvement organization and collaborates significantly with the HQRI Senior Leadership Team in planning and executing its Stars and risk adjustment strategy and programs.
This is a remote position with preference given to Central or Eastern time zones.
Major responsibilities include:
Serve as HQRIs clinical industry representative (e.g., Conferences, national vendor or provider partners)
Inform HQRIs provider strategy and increase adoption of Humana's Stars, MRA, and interoperability strategy and programs
Lead a team/organization of 10 associates across three functions: Education of Humana's Market-based associates on how to drive accurate reporting; Provider communications; policies and procedures aligned to those functions
Serve as a coding expert, which may include working through escalations on coding disputes, policy development or refinement, and coordination and education with providers or Humana associates
Required Qualifications
MD or DO degree
A current and unrestricted license in at least one jurisdiction
Board Certified in an approved ABMS Medical Specialty
Excellent communication skills, both written and verbal
5 years of established clinical experience
Knowledge of the managed care industry including Medicare, Medicaid and / or Commercial products
Must be passionate about contributing to an organization focused on maintaining accuracy of coding and documentation to capture the true health status of our members thru risk adjustment initiatives
Experience with quality assurance and/or regulatory compliance
Travel up to 25%
Preferred Qualifications:
Certification in diagnosis coding (must be receive AAPC certification within one year of hire)
Ability to help develop and use data and analytics to drive sustainable results
External communications for physicians and healthcare providers
Prior experience leading teams focusing on the accuracy of medical record documentation and diagnosis coding
Medical management experience, working with health insurance organizations, hospitals and other healthcare providers, patient interaction, etc.
Working knowledge of risk adjustment concepts
Internal Medicine, Family Practice, Geriatrics, OBGYN, Hospitalist clinical specialty
Detail oriented and effective listener
Experience with Stars, including HEDIS, CAHPS and HOS
Prior experience in a business function or business consulting role
Additional Information:
Vaccine Policy
Humana and its subsidiaries require vaccinated associates who work outside of their home to submit proof of vaccination, including COVID-19 boosters.
Associates who remain unvaccinated must either undergo weekly negative COVID testing OR wear a mask at all times while in a Humana facility or while working in the field
Scheduled Weekly Hours
40
Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our ****
DescriptionHumana is a $90 billion (Fortune 40) market leader in integrated healthcare with a clearly defined purpose to help people achieve lifelong well-being. As a company focused on the health and well-being of the people we...
DescriptionThe Technology Chief Financial Officer, ('Tech CFO ') is responsible for financial leadership of Humana's global Tech operations, including strategy and execution from new project prioritization and planning to ongoi...
***This role is based at one of our corporate offices in McLean, VA, Dallas, TX, or Memphis, TN***From smartphone capabilities like Digital Key to Hilton Connected Room that allow for integrated entertainment, temperature, and l...
#J-18808-Ljbffr
Email Alert for AVP MD Stars and Risk Adjustment Clinical Strategy and Leadership jobs in Washington, DC, United States
ⓘ There was an unexpected error processing your request.
Please refresh the page and try again.
If the problem persists, please contact us with your issue.
You can always manage your preferences and update your interests to ensure you receive the most relevant opportunities.
Get ready to discover your next great opportunity.