- Molina Healthcare (OH)
- **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
- Molina Healthcare (OH)
- …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
- Molina Healthcare (Cincinnati, OH)
- …+ Extensive understanding of Medicare Advantage, ACA and Medicaid risk adjustment processes, including encounter data submission and deletion requirements ... **Job Description** **Job Summary** The AVP, Risk Adjustment Encounters is responsible for...processes that track, evaluate, and submit encounter deletions for Medicare Advantage, ACA, and Medicaid lines of business. This… more
- Humana (Columbus, OH)
- …a pivotal role within Humana, delivering insights that drive the effectiveness of risk adjustment initiatives. In this position, the Senior Research Scientist ... advanced statistical methods to rigorously evaluate the impact of risk adjustment programs and pilot projects. The...will collaborate with colleagues specializing in data science and actuarial analytics. We are seeking a candidate who brings… more
- Humana (Columbus, OH)
- …a pivotal role within Humana, delivering insights that drive the effectiveness of risk adjustment initiatives. In this position, the Research Scientist 2 will ... advanced statistical methods to rigorously evaluate the impact of risk adjustment programs and pilot projects. The...will collaborate with colleagues specializing in data science and actuarial analytics. We are seeking a candidate who brings… more