- AmeriHealth Caritas (Newtown Square, PA)
- …financials and analyzing emerging issues + Informs rate setting with validation of Medicaid pricing and ad hoc requests from agencies + Works collaboratively ... **Responsibilities:** The **Associate Actuary ** will collaborate with team members and other...actuarial services to the organization. This position will support ** Medicaid Markets.** **Work Arrangement** + This is a 100%… more
- Humana (Honolulu, HI)
- …caring community and help us put health first** Design and maintain Medicaid claims analytics dataset using Databricks. Conduct in-depth analysis of healthcare ... and reporting. Identify cost drivers, utilization patterns, and anomalies in Medicaid medical claims data. Maintain dashboards to communicate key trends to… more
- Prime Therapeutics (Jackson, MS)
- …of actuarial work experience in a healthcare organization or PBM + Previous experience pricing Commercial, Medicare or Medicaid lines of businesses + 5 years of ... our passion and drives every decision we make. **Job Posting Title** Principal Actuary **Job Description** The Principal Actuary is responsible for supporting… more
- Banner Health (Phoenix, AZ)
- …organizations to coordinate rate filings and year-end financials. Is responsible for all pricing , rate development and filings for all products. This role will also ... analyzing, developing, and/or submitting Medicare Advantage and Prescription Drug plan bid pricing tools and/or plan benefit packages. This role will ensure the… more
- CVS Health (Frankfort, KY)
- …guidance to the health plan and external partners for the state Managed Medicaid pharmacy benefit. The Pharmacy Director reports to the Senior Lead Pharmacy Director ... and operational aspects of pharmacy and prescription drug services within the Kentucky Medicaid health plan and to execute the Pharmacy Benefit in accordance with… more
- Somatus (Mclean, VA)
- …position the company for a successful IPO (~4 year goal) + In partnership with Actuary / MedEcon, lead pricing and contract term development and negotiation to ... projects and meet tight deadlines + Comprehensive knowledge of Medicare, Medicaid , and commercial policies, processes, and procedures Travel Requirements: + Ability… more