- Highmark Health (Pittsburgh, PA)
- …CMS programs focused on provider innovation. This position will also be accountable for; developing a shared capability and implementation roadmap that is consistent ... successful candidate will collaborate with key partners across the enterprise including actuary , finance, and reimbursement operations to build the ROI frameworks of… more
- Highmark Health (Harrisburg, PA)
- …lieu of degree **Preferred** + None **EXPERIENCE** **Required** + 3 years of Health Care Underwriting OR risk mgmt OR actuary work OR applying advanced ... as risk scores, demographic analysis, and turnover considerations. + Serve as the accountable owner for all quotes delivered to sales partners. Develop a perspective… more
- Highmark Health (Blue Bell, PA)
- …revenue and cost trends to achieve revenue targets and improve quality of care for our members. Drives the coordination with multiple stakeholders to implement and ... adjusted government programs (Medicare Advantage, ACA business, and Medicaid). Also work with Care Management to ensure that this information is used to improve the… more
- Geisinger (Danville, PA)
- …Compliance and technical interpretive discussions with benefit counsel and enrolled actuary or consultants. Job Duties + Monitors eligibility, limitations, and ... surveys. Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying...INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and… more