- MAPFRE Insurance (Albuquerque, NM)
- …and underwriting guidelines. + Lead the creation of forecasting models and actuarial data to support new and existing programs. + Collaborate across departments ... to ensure seamless implementation of risk strategies. + Conduct quarterly reviews to identify underwriting issues and recommend solutions. + Drive business intelligence initiatives to enhance decision-making and operational effectiveness. ** What You Bring** +… more
- Premera Blue Cross (Mountlake Terrace, WA)
- …+ Partner with PBM partners on rebate strategy and coding, and with actuarial and clinical operations teams to assess rebate opportunities and model financial ... impacts of formulary decisions. + Provide leadership and support for the P&T Committee, including implementing strategic changes in service of broader formulary and departmental long-term plans. Drive formulary updates and maintenance across multiple lines of… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …submits adjustments to the appropriate processing / adjustment area (Risk Adjustment/ Actuarial Services). * Performs vendor Quality Assurance (QA) and sole source ... PUD coding projects, including over read assignments. May support vendor discussions and feedback related to quality audit findings. Presents results and learning opportunities to the team. * Serves as a coordinator and key business resource for the Risk… more
- Deloitte (Tallahassee, FL)
- …+ Successfully passed at least two Society of Actuaries (SOA) or Casualty Actuarial Society (CAS) exams, or achieved Associate-level status (ASA/ACAS) or higher. The ... wage range for this role takes into account the wide range of factors that are considered in making compensation decisions including but not limited to skill sets; experience and training; licensure and certifications; and other business and organizational… more
- Elevance Health (Norfolk, VA)
- …+ Substantial analytical experience in the healthcare industry is preferred. + Actuarial experience within a healthcare and/or managed care organization preferred + ... Familiarity with medical management or population health programs preferred. + Possess working knowledge of healthcare data and measurement standards such as ICD10, CPT/HCPCS, MS-DRG, DxCG, PMPM, and utilization per 1,000, preferred. + Advanced SQL and Excel… more
- CareFirst (Baltimore, MD)
- …leaders at the Health System as well as legal, financial, contracting, and actuarial teams at CareFirst to collaboratively coordinate and implement efforts of the ... Partnership. Works with health system leadership to create programs that will drive growth and enhance business performance in key market segments. + Responsible for management and oversight of relationship with any additional consultants/vendors CareFirst may… more
- State of Georgia (Fulton County, GA)
- …classification, based on available collateral case documentation, and empirically supported actuarial risk assessments, to determine the sexual recidivism risk a ... convicted sex offender living in Georgia poses to the community. Summary of essential job functions Risk Classification Report: Review and summarize within a report the criminal history, criminal documents, prison and supervision history, and treatment… more
- Zurich NA (Dallas, TX)
- …vendor utilization and litigation strategy development. + Financial and actuarial /reserving concepts comprehension. + Familiarity with negotiation strategies and ... alternative approaches. + Strong organizational and time management skills. + Customer service experience. + Strong analytical, critical thinking, and problem-solving skills. + Excellent verbal and written communication skills. At Zurich, compensation for… more
- WTW (Chicago, IL)
- **Description** Our Retirement team combines expertise in retirement, actuarial and compliance consulting to support global organizations worldwide in designing, ... managing, administering, and communicating all types of retirement plans. Whether a client has a defined benefit pension, a defined contribution plan, and/or a nonqualified plan, we collaborate with the organization to determine the right approach to design,… more
- State of Massachusetts (Northampton, MA)
- …for the client if the client desires such. 9. Cross-train in actuarial assessment tools for risk/need, treatment planning, and contingency management protocols as ... needed. 10. Facilitate aftercare or alumni groups for Support Center clients. 11. Transport Support Center client as required. Education: a. Bachelor's degree or b. lived experience and i. some record of educational development such as certificate, college… more