CareSource
1001 - 5000 employees
Founded 30+ years
⚕️ Healthcare Insurance
Healthcare Insurance
CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.
Quality Risk Adjustment Advisor IV, Health Plan Experience Required
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🔥 0 minutes ago
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CareSource
1001 - 5000 employees
Founded 30+ years
⚕️ Healthcare Insurance
Healthcare Insurance
CareSource is a health services company focused on providing affordable health insurance and healthcare solutions. It offers a wide range of plans including Medicaid, Marketplace, and Medicare Advantage, targeting low-income adults, families, children, pregnant women, elderly adults, and people with disabilities. Additionally, CareSource provides members with resources for COVID-19 support, dental, vision, and hearing benefits, as well as pharmacy services. The company emphasizes easy access to healthcare management through online platforms and a mobile app.
📋 Description
• Lead key components of the Quality Risk Adjustment (QRA) programs • Ensure compliance with regulatory standards • Optimize quality outcomes • Partner with internal stakeholders and external vendors • Enhance operational effectiveness and leverage AI technologies
🎯 Requirements
• Bachelor's degree in Health Administration, Healthcare Management, or a related field required • Seven (7) years experience in risk adjustment, medical record review, coding, or quality management required • Two (2) years experience with AI solutions in a healthcare setting required • Knowledge of ICD-10 Coding • Knowledge of HCC Risk Adjustment models • Knowledge of CMS regulatory guidelines
🏖️ Benefits
• Comprehensive total rewards package • Bonus tied to company and individual performance
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