Medicare STAR - Huntington Beach, CA

Verda Healthcare is a newly launched Medicare Advantage Plan led by a purpose-driven team of experienced healthcare professionals. The company is committed to ensuring healthcare is accessible and equitable for all individuals. · ...

Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining analysis modeling and predicting to enable informed business decisions. · ...

Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. · ...

Designs and implements processes and solutions associated with a wide variety of data sets used for data/text mining, analysis, modeling, and predicting to enable informed business decisions. · ...

Job summaryAccountable for developing continuous improvement strategies and directing implementation that delivers operational excellence resulting in high performance in CMS Star and Medicare Risk Adjustment MRA program. · Bachelor's degree in Business Healthcare or related fiel ...

We are seeking a VP, Risk Adjustment & Quality to take ownership of the strategic integration between revenue integrity and clinical outcomes. In this role, you will oversee the complete lifecycle of risk capture including prospective, concurrent, and retrospective workflows whil ...

We are seeking a VP Risk Adjustment & Quality to take ownership of the strategic integration between revenue integrity and clinical outcomes. · Strategic Execution: Develop and execute enterprise-wide Medicare Advantage risk adjustment strategies aligned with CMS requirements. · ...

Description · Are you ready to make a lasting impact and transform the healthcare space? We are one of Southern California's fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth.    · Who Are We?   · Clever Care was created to meet the ...

Description · Are you ready to make a lasting impact and transform the healthcare space? We are one of Southern California's fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth.   · Who Are We?   · Clever Care was created to meet the ...

Description · Are you ready to make a lasting impact and transform the healthcare space? We are one of Southern California's fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth.    · Who Are We?   · Clever Care was created to meet the ...

The Appeals & Grievances Resolution Specialist supports the intake, · investigation, and resolution of member grievances, · appeals, provider disputes, and complaints in accordance with CMS · regulations. · Ensure cases are processed within required turnaround times accurately tr ...

This is a hybrid position in Huntington Beach CA Candidate must resident in Los Angeles Orange County or surrounding areas Are you ready to make a lasting impact and transform the healthcare space We are one of Southern California's fastest-growing Medicare Advantage plans with a ...

Description · This is a hybrid position in Huntington Beach, CA. Candidate must resident in Los Angeles, Orange County or surrounding areas. · Are you ready to make a lasting impact and transform the healthcare space? We are one of Southern California's fastest-growing Medicare A ...

Vice President of Risk Adjustment is responsible for the strategic integration of revenue integrity and clinical outcomes. Oversees risk capture workflows while ensuring high performance in quality metrics such as CMS Star Ratings and HEDIS. · Develop and execute the enterprise-w ...

This is a hybrid position in Huntington Beach. The Vice President of Population Health Management (PHM) provides enterprise-wide leadership for strategies that integrate utilization management, care management, and population health initiatives to improve quality, affordability, ...

We are seeking a VP to take ownership of the strategic integration between revenue integrity and clinical outcomes. · ...

We are one of Southern California's fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth.Clever Care was created to meet the unique needs of the diverse communities we serve. · Bachelor's degree in Business, Healthcare, or related fiel ...

The Star Programs Specialist is responsible for assisting with the deployment and implementation of member experience improvement strategies, collecting and tracking member feedback from all channels in the organization. · ...

The HEDIS/Risk Outreach Coordinator is responsible for assisting with the deployment and implementation of various Stars and Risk adjustment programs tied to medical records retrieval strategies, · Candidate will work with the Stars and Risk team to collect member records and con ...

Are you ready to make a lasting impact and transform the healthcare space? We are one of Southern California's fastest-growing Medicare Advantage plans with an incredible 112% year-over-year membership growth. · Clever Care was created to meet the unique needs of the diverse comm ...