- Molina Healthcare (Columbus, GA)
- **JOB DESCRIPTION** **Job Summary** Responsible for Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and ... scores, and analyze impact. **KNOWLEDGE/SKILLS/ABILITIES** + Collaborate with Actuarial staff to calculate risk adjustment...+ Collaborate with Actuarial staff to calculate risk adjustment payment estimates. Document assumptions. +… more
- Elevance Health (Atlanta, GA)
- ** Risk Adjustment Actuarial Analyst II -...complex actuarial studies related to risk adjustment analytics in both the Medicaid and Medicare ... an accommodation is granted as required by law._ The ** Risk Adjustment Actuarial Analyst II...develops SAS and SQL programming to support Medicaid and Medicare Advantage risk adjustment initiatives.… more
- CVS Health (Atlanta, GA)
- …regulatory compliance. + Serve as a subject matter expert on CMS regulations, risk adjustment , and revenue optimization. + Collaborate with internal stakeholders ... CMS Part C/D operations. + 5+ years' experience working with CMS regulations, risk adjustment methodologies, and revenue management. + 5+ years' experience… more
- Elevance Health (Columbus, GA)
- ** Medicare Risk Adjustment Advanced Analytics Consultant** **On-Site Requirement: Hybrid 1;** **This role requires associates to be in-office 1 - 2 days per ... an accommodation is granted as required by law._ The ** Medicare Risk Adjustment Advanced Analytics...writing errors and rework. + Assists in training of actuarial trainees, analysts, and specialists. + Consults on all… more
- Molina Healthcare (Atlanta, GA)
- …Analytics role will be responsible for work around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research, analysis ... complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data to evaluate healthcare...risk models including the various CMS models for Medicare Advantage members, the HHS model for Commercial ACA… more