About Us

The RISE Association (Resource Initiative & Society for Education) is a national association dedicated to supporting the health plan and provider organizations involved in the healthcare reform movement, particularly those involved in the government programs markets such as Medicare Parts C & D, Affordable Care Act health insurance exchanges, special needs plans for dually-eligible individuals, Medicaid plans for needy populations, Accountable Care Organizations and MACRA initiatives. 

 

RISE Vision and Mission

To build a community and an educational system that promotes successful careers for professionals who are advancing the Triple Aim of healthcare. RISE provides:

  • A forum to build professional identity and a network of colleagues
  • A platform to capture and share knowledge and insights
  • A venue to develop and share benchmarks and document best practices
  • Career track development support
  • A channel for building alliances, partnerships and affiliations that fulfill the vision

RISE is the first national association totally dedicated to supporting healthcare professionals who aspire to meet the challenges of the emerging landscape of accountable care and healthcare reform. We strive to serve our members on four fronts: Education, Industry Intelligence, Networking and Career Development.

  • Education: Through cutting-edge conferences, webcast presentations, job-specific educational curricula, and industry-driven library resources, RISE provides our members with the crucial information they need to stay ahead of the curve. We also actively apply to industry credentialing organizations to ensure that professionals optimize every opportunity our programs offer to earn CEUs.
  • Industry Intelligence: RISE brings the marketplace to members in a collaboration between technical experts, solutions vendors and expert speakers.
  • Networking: RISE members make valuable connections with other healthcare professionals from across the nation, from every section of the industry. Through meaningful networking opportunities and roundtables, RISE brings together multiple perspectives and facilitates highly interactive discussion between professionals. Members hear the best (and worst) practices directly from their peers, and gain valuable insight into market trends.
  • Career Development: RISE members will have access to support tools, career-oriented curricula and networking to enhance their job skills and career tracks.

Who Should Join

RISE was designed to bring together healthcare professionals from all industry segments whose job functions are directly impacted by the continuing evolution of accountable healthcare financing and delivery, health care reform developments, and emerging topics.

Members include professionals working for:

  • Health Plans
  • Physician Organizations, Medical Groups, IPAs
  • Accountable Care Organizations
  • Management Services Organizations & practice management
  • Hospitals & integrated delivery systems
  • Skilled Nursing, Long Term Care and Chronic Care Facilities
  • Medical homes  
  • Sole proprietors or independent consultants 
  • People who are in transition between jobs that would otherwise qualify them for standard membership

With a range of positions: C-Suite roles, Vice Presidents, Directors, Managers, Supervisors and Professional Staff for

  • Quality assurance/improvement
  • Care Coordination, Medical Management, Population Health
  • HEDIS, Stars, Quality Measurement or  Marketplace/QRS
  • HCC coding & revenue
  • Risk adjustment and financial management
  • Compliance and government relations
  • Medical informatics
  • Network development & management
  • Provider engagement
  • Data analytics
  • Operations, claims, member service, enrollment, billing & reconciliation
  • Physician education & engagement
  • Product development & innovation
  • Medicare marketing & sales
  • Member engagement
  • Health Insurance Exchanges and the new Marketplace products
  • Business development & strategic planning

Benefits of Membership

Healthcare professionals are eligible for Standard Membership with RISE, which grants access to:

  • RISE-exclusive webcasts and educational webinars throughout the year
  • RFP Support for identifying qualified vendor support services and competitive bidding
  • Updates on the development of formal educational courses and career support tool development
  • Priority notification of RISE conferences and webinars

Membership Composition

 

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Association Sponsors

Latest Posts

Nuance and Talix Team to Improve Care Quality and Risk Adjustment at the Point of Decision Making

New Quality and Risk Adjustment Solution from Nuance Combines AI and Coding to Deliver Context-Aware, Personalized Clinical Guidance to Providers BURLINGTON, Mass. and SAN FRANCISCO, October 11, 2017 – Nuance Communications, Inc. and Talix, Inc. today announced a reseller agreement to deliver a new patient-focused solution to support better outcomes and risk adjustment through decision support and automation. As a result of this agreement, Nuance introduced a new Nuance Quality and Risk Adjustment solution that combines Talix’s risk adjustment coding technology with Nuance’s artificial intelligence (AI)-powered Computer-Assisted Physician Documentation (CAPD) solutions. This new offering from Nuance will enable population health specialists, care providers and coders to quickly and easily find and close coding gaps at the point of care, and properly code high value risk adjustment opportunities. With the emergence of new care and payment models, providers are shouldering an increasing amount of accountability and financial risk while also needing to provide comprehensive care and disease management across the continuum of care in a dynamic, value-based environment. As care increasingly shifts toward an ambulatory setting, effective population health management strategies that proactively identify and assess high-risk patients, and improve...
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Episource Acquires Peak Payer Solutions, Expanding Capabilities into Health Risk Assessments and Clinical Services

Acquisition brings together Peak’s prospective in-home health assessments and retrospective chart audit capabilities with Episource’s best-in-class Risk Adjustment and HEDIS/Stars services and technology offerings LOS ANGELES, CA., September 25, 2017 – Episource announced today that it has signed a definitive agreement to purchase Peak Payer Solutions, a provider of risk adjustment chart audits, and in-home health risk assessments for health care payers. Peak has a nationwide network of over 750 healthcare providers across all 50 states....
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Upcoming Conference

 

The Risk Adjustment Forum: Operational Integration and Compliance 

This is your can't-miss opportunity to gain proven strategies for enhancing the compliance of your coding and risk adjustment data. You also will get unparalleled insight and tools to help streamline the integration of risk adjustment and quality initiatives, and take away critical lessons learned from plans breaking down operational silos. You will also hear directly from CMS! 

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Upcoming Webinar

Quality Visits: Closing Gaps in Care to Meet Your Quality Performance Goals

Meeting and exceeding quality standards has never been more important for health plans as reimbursement is increasingly linked to specific quality goals. This informative webinar will help you understand how to gain control over meeting your quality goals by executing targeted interventions for those members with gaps in care. You’ll get a glimpse of how to coordinate everything from member outreach and engagement, to actual gap closure and reporting to the member, their primary care provider and the health plan.

 

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