- Molina Healthcare (Austin, TX)
- **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
- Deloitte (Dallas, TX)
- …care and fee-for-service, Medicaid policy, budget forecasting and fiscal analyses, and risk adjustment + Support business development efforts for Federal and ... Experience with Medicaid waivers (ie, 1115, 1915 b/c, 1332) + Experience with risk adjustment mechanisms + Experience with Provider reimbursement streams (ie,… more
- Deloitte (San Antonio, TX)
- …for other Health Plan Actuarial liabilities for Premium Deficiency Reserves, Medicare Risk Adjustment , MLR (Minimum Loss Ratio) Calculations, Provider ... The job functions include Client project engagements in Deloitte Human Capital's Health Actuarial Plan & Insurance Center of Excellence (HAPI COE) which involve: +… more
- Molina Healthcare (Fort Worth, TX)
- …+ 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
- CVS Health (Austin, TX)
- …consulting, financial strategic analysis. + Understanding of value-based care, including risk adjustment methodologies (eg, HCC coding), quality measurement ... the impact of efforts and adjusting strategies accordingly + Work closely with Medicare Quality team to ensure that reporting highlights areas of improvement at a… more