Responsible for developing, implementing, maintaining, monitoring and overseeing the company's risk adjustment initiatives for Integrity and commercial health exchange programs. Oversight of vendor activities related to risk adjustment. This will include evaluating the policies and procedures used for the Risk Adjustment program to ensure compliance with all Centers for Medicare and Medicaid Services (CMS) and Rhode Island regulatory guidelines.
Manage Risk Adjustment Accounting Requirements:
Regulatory Oversight and Quality Assurance:
Provider Engagement, Training and Support
Analysis and Use of Results
Enterprise Risk Adjustment
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Neighborhood is an EOE M/F/D/V and an E-Verify Employer