Essential Duties and Responsibilities: - Audit medical records to ensure compliance with the Medicare Advantage Risk Adjustment standards including abstraction and assignment of appropriate codes based on clinical data. - Enter coded data into a system accurately and
Essential Duties and Responsibilities: - Lead and execute sensitive, high-risk investigations (e.g., harassment, discrimination, retaliation, serious misconduct), including matters involving senior leaders and significant organizational risk; gather evidence, conduct interviews, assess credibility, and document findings. -
Essential Duties and Responsibilities: - Responsible for directing all quality operations including planning, implementation monitoring and reporting functions. - Develop and oversee an effective management system to continuously identify opportunities for improvement while maintaining adherence to