- Elevance Health (West Des Moines, IA)
- ** Risk Adjustment Actuarial Analyst II -...complex actuarial studies related to risk adjustment analytics in both the Medicaid and Medicare ... an accommodation is granted as required by law._ The ** Risk Adjustment Actuarial Analyst II...develops SAS and SQL programming to support Medicaid and Medicare Advantage risk adjustment initiatives.… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Medicare Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and ... the impact of any changes to the HCC model and supporting actuarial in the calculation risk adjustment revenue. + Assists in designing an overall suite… more
- Amazon (Seattle, WA)
- …economics reporting and ad-hoc analysis relating to cost of care management - Medicare Risk score projections and premium estimation -Design and implement ... -Value based care contracting support and ongoing financial and risk analysis. -Support ongoing actuarial support for...(ASA) is required -Experience with Medicare or Medicare Advantage products -Strong knowledge of actuarial … 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 ... you to apply! Job Description: Summary: The Manager of Actuarial Services is responsible for managing a team that...+ Leads preparation of accruals/liabilities for CMS Part D risk sharing and Part C revenue settlements. + Leads… more
- Fallon Health (Worcester, MA)
- …of actuarial components of financial reports, regulatory submissions, and risk adjustment analyses + Collaborate with cross-functional teams including ... **Primary Job Responsibilities** + Assist in the development and maintenance of actuarial models for valuation, forecasting, pricing, and/or risk analysis +… more
- Deloitte (Colorado Springs, CO)
- …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
- Point32Health (Canton, MA)
- …will oversee all provider engagement and reporting activities for risk adjustment programs and initiatives that impact Medicare , Medicaid, and Duals product ... Point32Health (https://www.point32health.org/) . **Job Summary** This position will lead the Risk Adjustment Operations & Provider Consulting team responsible… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …vendor performance relative to established contracts. * Collaborate with actuarial , finance, Medicare and risk adjustment to ensure all inputs and ... Medicare Provider Relations team! You will apply broad actuarial principles and modeling technical skills to develop solutions...with actuarial , finance, data & analytics, stars, risk adjustment , and other lever owners to… more
- Centene Corporation (Tallahassee, FL)
- …with data mining, machine learning, artificial intelligence, or statistical modeling preferred ** Risk Adjustment :** Experience in risk adjustment , ... preferred. Familiarity with claims payment, utilization management, provider/vendor contracts, risk adjustment for government sponsored healthcare desired.Pay… more
- Point32Health (NH)
- …in a matrix environment collaborating with functions including risk adjustment , population health, finance, operations, actuarial , and sales. **Job ... and products. The Director will lead a team who negotiates contracts including risk arrangements to enable high performing provider networks that support goals for… more