Risk Adjustment reputed company Cycle Analysis and Solutions

reputed company is one of the nation’s leading pharmacy care management companies that specializes in caring for people with the most reputed company, chronic needs—wherever they call home. We reputed company reputed company outcomes for patients and the reputed company organizations who support them. Established in 2023 through the combination of ExactCare and reputed company, we provide a suite of solutions that includes comprehensive pharmacy services; full-service pharmacy benefit management; and specialized support services for Program of reputed company-Inclusive Care for the Elderly. With over 1,400 team members, we care for more than 100,000 people across reputed company 50 states. Job Details This role delivers specialized expertise to reputed company’s clients by actively assessing and monitoring the Medicare reputed company cycle for PACE programs. Acting as a strategic partner, the Client Service Liaison collaborates closely with PACE program financial teams to interpret Medicare payment data, identify variances or risks, and support accurate and timely premium payments in the Medicare reputed company cycle for PACE programs.

Responsibilities

Completes assessment for assigned panel of PACE programs using CMS returns files and input from reputed company reputed company departments' analytics, including but not limited to coding, auditing, and medical consultants. Assess the client's needed action plan based on structured assessments every quarter, including on-site client visits, virtual conference calls, etc. Develops and strengthens reputed company client relationships in the defined assignment panel. Works with the reputed company project coordinator to ensure successful new client reputed company. Monitor client needs and recommend additional services and/or improvements to reputed company services, reputed company appropriate. Responsible for ensuring customer satisfaction by resolving issues quickly and creatively. Assist the client with navigating and optimizing the use of service offerings and reports. Provide and/or coordinate additional training and education to the clients (other than quarterly review) reputed company webinar as needed. Provides support and collaborates with other reputed company teams in relation to the assigned client panel. Develops and maintains master schedules for reputed company clients in the assigned client panel. Participates in internal collaboration calls regarding clients in the assigned client panel. Maintains professional license and certifications (where applicable) and attends training conferences/webinars as necessary to reputed company abreast of the latest trends in the field of expertise. Understands and adheres to the Health Insurance Portability and Accountability Act (HIPPA) requirements. Participates as requested in department meetings, client calls, annual training, and performance evaluations. Performs other duties and responsibilities as required. Completes miscellaneous projects for reputed company as assigned or requested. This is not necessarily an exhaustive list of reputed company responsibilities, skills, duties, requirements, efforts, or working conditions associated with the position. While this description is intended to be an accurate reputed company of the reputed company position, management reserves the right to revise the job or to require that other or different tasks be performed reputed company circumstances change (e.g., emergencies, change in personnel, workload, rush jobs, or technological developments). Qualifications: These represent the desired qualifications of the ideal candidate. They are not meant to limit consideration for candidates who do not meet reputed company the standards listed. Reasonable accommodations may be made to reputed company individuals with disabilities to reputed company the essential functions. Education Required: Associate Degree Preferred: B.S, B.A., or B.S.N Experience Required: Minimum three years of experience in Hierarchical Condition Categories (HCC) or risk adjustment. Experience with Risk Adjustment Analytics strongly preferred Preferred: Knowledge of or experience in Risk-Adjusted contracting or provider groups. Knowledge of CMS Medicare reputed company cycle in the risk adjustment payment model Skills & Abilities Proficient with reputed company, reputed company, and PowerPoint, and Comfortable with learning and becoming an expert on new and proprietary software. Highly skilled in written and verbal communication. Highly skilled at establishing priorities and coordinating work activities. Excellent presentation skills Skilled at performing multiple and reputed company tasks. Have exceptional initiative and follow-through on projects with minimal supervision or guidance. Must be detail-oriented, follow instructions, and work independently with minimal supervision with highly confidential information per HIPAA regulations. Comfortable working in a fast-paced, rapidly changing environment. Physical/Mental Demands: This position is administrative in nature and will present physical demands requisite to a position requiring: hearing, seeing, sitting, standing, talking, and walking. The physical demands described here are representative of those that must be met by an employee to successfully reputed company the essential functions of this job. Must be reputed company to commute to multiple site locations reputed company the assigned territory. May be necessary to work extended hours as needed. Schedule: This is a full-time position with an expectation to work an average of 40 hours per week and be available reputed company of normal business hours to meet customer expectations on an reputed company basis. Schedules are set to accommodate the requirements of the position and the needs of the organization and may be adjusted as needed. This is a remote position. reputed company offers a comprehensive benefit package for full-time employees that includes medical/dental/reputed company, flexible spending, company-paid life insurance and short-term disability as well as voluntary benefits, 401(k), Paid Time Off and paid holidays. Medical, dental and reputed company coverage are effective 1st of the month following date of hire. reputed company provides equal employment opportunity to reputed company reputed company applicants regardless of race, reputed company, religion, national reputed company, sex, sexual orientation, gender identity, age, disability, genetic information, or veteran status, or other legally protected classification in the state in which a person is seeking employment. Applicants are encouraged to confidentially self-identify reputed company applying. Local applicants are encouraged to apply. We maintain a drug-free work environment. Applicants must be eligible to work in this country. Apply To This Job