• Director Reimbursement Design & Market Evaluation

    Highmark Health (Baton Rouge, LA)
    …change to drive adoption and ROI realization. Critical partners include Advanced Analytics , Contracting, Market and Provider support teams, Actuary , Finance, ... To be successful, the incumbent will work closely with stakeholders across the enterprise in the development and implementation of an integrated roadmap for the… more
    Highmark Health (07/30/25)
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  • VP Risk Adjustment Accuracy Management

    Highmark Health (Blue Bell, PA)
    …capabilities. Builds strong analytical functions to focus resources on providing optimal financial returns in a fully compliant manner. Develop a Risk Management ... governance strategy for the Enterprise to appropriately manage CMS audit risk. **ESSENTIAL RESPONSIBILITIES:**...evolves the models and guidance. + Accountable for achieving financial targets related to risk adjustment activities and complying… more
    Highmark Health (07/30/25)
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  • Director, Medical Cost Economics

    UPMC (Pittsburgh, PA)
    …of datasets to inform key analyses. + Build strong relationships with Actuarial, Analytics , and Finance teams across the enterprise . + Ensure that departmental ... **Purpose:** The Department of Health Economics is seeking a credentialed health actuary with a strong background analyzing claims data. This position would drive… more
    UPMC (06/21/25)
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  • Corporate Director Network Strategy

    AmeriHealth Caritas (Newtown Square, PA)
    …TheCorporate Director, Network Strategy is responsible for developing and managing an enterprise network strategy function, with a focus on optimizing total network ... provider network strategies based on advanced market research, intelligence and analytics to drive strategic network decisions and new programs + Responsible… more
    AmeriHealth Caritas (07/27/25)
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