Highmark Health
Santa Fe, NM
Company : Highmark Inc. Job Description : JOB SUMMARY This job is responsible for developing plans and managing activities in support of Risk Adjustment and Quality/HEDIS. Directs the daily activities of direct reports supporting Risk Adjustment Coding and Quality/HEDIS. Assesses viability of current direction/projects/operations and recommends strategies and tactics to satisfy current and future business needs. Actively seeks and identifies opportunities for improvement. Implements strategic and tactical improvements to the Risk Adjustment Coding and Quality/HEDIS processes. Manages information that will ensure accurate and efficient projects. Responsible for working with appropriate departments in the areas of risk adjustment, compliance, process improvement and member/provider satisfaction for all product lines. Recommend and/or implements process improvements related to the potential of quality medical care and service. Serves as a resource regarding government...

