- Elevance Health (New Hyde Park, NY)
- ** Risk Adjustment Actuarial Analyst II - Advanced Analytics** **On-Site Requirement:** **Hybrid 1;** **This role requires associates to be in-office 1 - 2 ... granted as required by law._ The ** Risk Adjustment Actuarial Analyst II - Advanced Analytics**...performing complex actuarial studies related to risk adjustment analytics in both the Medicaid and Medicare… more
- Molina Healthcare (Yonkers, NY)
- …of key managed care concepts and provider reimbursement principles such as risk adjustment , capitation, FFS (Fee-for-Service), Diagnosis Related Groups (DRG's), ... ability to convert observations into actions/interventions to improve financial performance. * Advanced understanding of Medicaid and Medicare programs or other… more
- Deloitte (New York, NY)
- …reimbursement, MS-DRG, APR-DRG, PSIs, HACs, POA, Vizient, Elixhauser, public profiling, and risk adjustment + Has strong interpersonal skills to collaborate with ... Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk & Forensic team helps client leaders translate multifaceted risk … more
- Excellus BlueCross BlueShield (Rochester, NY)
- …and external to ensure accuracy. Leads preparation reporting, valuation, and forecasting of risk adjustment scores and revenue to support partners internal and ... experience supervising or managing people and/or projects or indirectly leading teams. + Advanced knowledge of financial and risk health arrangements. + Strong… more