• Consulting Actuary - Medicare Risk…

    BlueCross BlueShield of North Carolina (NC)
    **Job Description** As a Consulting Actuary at our healthcare organization, you will play a pivotal role in shaping the future of care delivery through ... innovative insurance products, optimizing pricing strategies, or evaluating advanced care management models. Your work will support key organizational goals… more
    BlueCross BlueShield of North Carolina (09/05/25)
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  • Executive Director, Chief Actuary

    Banner Health (Phoenix, AZ)
    …as part of your Total Rewards package. Banner Health Network (BHN) is an accountable care organization that joins Arizona's largest health care provider, ... Shift:** Day **Job Category:** General Operations Help lead health care into the future. As one of the largest...Banner Health, and an extensive network of primary care and specialty physicians to provide the most comprehensive… more
    Banner Health (08/23/25)
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  • Value-Based Innovation Consultant

    Highmark Health (Pittsburgh, PA)
    …CMS programs focused on provider innovation. This position will also be accountable for; developing a shared capability and implementation roadmap that is consistent ... successful candidate will collaborate with key partners across the enterprise including actuary , finance, and reimbursement operations to build the ROI frameworks of… more
    Highmark Health (09/05/25)
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  • Head of Pricing - North America Accident & Health

    AIG (Atlanta, GA)
    …Claims, Operations, Marketing and Risk Management, among other functions. As an AIG actuary , you will be challenged and encouraged to reach your greatest potential ... their goals and objectives, including staff development and project prioritization. + Be accountable for the A&H results and in partnership with the business develop… more
    AIG (07/19/25)
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  • Market Underwriter - HNAS

    Highmark Health (Topeka, KS)
    …lieu of degree **Preferred** + None **EXPERIENCE** **Required** + 3 years of Health Care Underwriting OR risk mgmt OR actuary work OR applying advanced ... as risk scores, demographic analysis, and turnover considerations. + Serve as the accountable owner for all quotes delivered to sales partners. Develop a perspective… more
    Highmark Health (07/02/25)
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  • Provider Transformation Specialist (RN- Western…

    Highmark Health (Buffalo, NY)
    …population health, ambulatory care setting quality and efficiency metrics, accountable care organization development and support, patient centered medical ... of the value-based reimbursement team, provider relations, senior markets, analytics, actuary and key internal/external stake holders to provide the most appropriate… more
    Highmark Health (09/10/25)
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  • Risk Adjustment Analyst

    Fallon Health (Worcester, MA)
    …dashboards and make recommendations for performance improvement + Attend meetings with Accountable Care Organiztions (ACOs) that Fallon Health shares risk with ... The RAA will also work with the Government Programs Actuary , product line management, Medical Economics and Care... Actuary , product line management, Medical Economics and Care Services to provide analysis and recommendations to improve… more
    Fallon Health (09/06/25)
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  • VP Risk Adjustment Accuracy Management

    Highmark Health (Blue Bell, PA)
    …revenue and cost trends to achieve revenue targets and improve quality of care for our members. Drives the coordination with multiple stakeholders to implement and ... adjusted government programs (Medicare Advantage, ACA business, and Medicaid). Also work with Care Management to ensure that this information is used to improve the… more
    Highmark Health (07/30/25)
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  • SVP, Finance

    Somatus (Mclean, VA)
    Overview As the largest and leading value-based kidney care company, Somatus is empowering patients across the country living with chronic kidney disease to ... successful IPO (~4 year goal) + In partnership with Actuary / MedEcon, lead pricing and contract term development...communicate healthcare cost trends, issues, and total cost of care drivers. + Assist leadership in developing and evaluating… more
    Somatus (06/18/25)
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  • Benefits Analyst

    Geisinger (Danville, PA)
    …Compliance and technical interpretive discussions with benefit counsel and enrolled actuary or consultants. Job Duties + Monitors eligibility, limitations, and ... surveys. Work is typically performed in an office environment. Accountable for satisfying all job specific obligations and complying...INNOVATION: We constantly seek new and better ways to care for our patients, our members, our community, and… more
    Geisinger (09/05/25)
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