- Molina Healthcare (Dayton, OH)
- …**Job Summary** Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintain risk adjustment model, ... available to lead national risk adjustment studies. Prior experience in Medicaid risk adjustment is not required. **KNOWLEDGE/SKILLS/ABILITIES** + Analyze risk score… more
- CVS Health (Hartford, CT)
- …and making sound, unbiased reports on these issues. **A Brief Overview** + Provide actuarial support for the **Texas and Oklahoma Medicaid ** plans. + Performs ... that produces returns to shareholders commensurate with the risks undertaken. Actuarial is responsible for anticipating and recognizing matters that materially… more
- CVS Health (Austin, TX)
- …across Aetna's Medicaid states. Within this role, you will: * Provide actuarial support for the Aetna Medicaid Behaviorial Health Centers of Excellence. * ... do it all with heart, each and every day. **Position Summary** This role supports the Medicaid team, specifically price monitoring and behaviorial health analytics… more
- CVS Health (Hartford, CT)
- … Pharmacy team, including forecasting, reporting and pharmacy analytics across all Medicaid states. Perform actuarial functions by applying expanded quantitative ... skills to recommend solutions and demonstrate and advanced understanding of actuarial concepts and business acumen. Set own priorities within pre-established overall… more
- CVS Health (Hartford, CT)
- …making sound, unbiased reports on these issues. **What you will do:** + Provide actuarial support for Medicaid markets. + Support business partners to enhance ... that produces returns to shareholders commensurate with the risks undertaken. Actuarial is responsible for anticipating and recognizing matters that materially… more
- CVS Health (Blue Bell, PA)
- …we do it all with heart, each and every day. **Position Summary** + Provide actuarial support for the Medicaid Revenue Integrity projects by + Continue to ... + Own the evaluation of certain projects and be the main actuarial contact in collaborating with business partners **Required Qualifications** + Passed at… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Medicaid Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and ... coordination of analytical processes, investigation and interpretation of Maryland Medicaid risk score methodology, risk score calculation, submissions, enrollment,… more
- Molina Healthcare (Spokane, WA)
- **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and ... and future contract rate proposals. * Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of reimbursement changes,… more
- Molina Healthcare (Scottsdale, AZ)
- **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and ... and future contract rate proposals. + Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of reimbursement changes,… more
- Centene Corporation (Austin, TX)
- …workplace flexibility. **Position Purpose:** Drives analytics and insights related to Medicaid , Marketplace, or Medicare programs with the objective of driving ... **Education/Experience:** Bachelor's degree or equivalent in Business Administration, Marketing, Actuarial Sciences, Applied Mathematics or Statistics. 5+ years of… more