- The Cigna Group (Houston, TX)
- …medical claims data (CPT/ICD10) + Experience with HHS ACA (or Medicare ) risk adjustment models; Healthcare Actuarial Modeling or financial modeling ... join the IFP Analytics team responsible for identifying and sizing new risk adjustment opportunities that not only create better health outcomes for patients but… more
- Molina Healthcare (Tampa, FL)
- **JOB DESCRIPTION** **Job Summary** Responsible for Medicare risk adjustment related estimates, establishing premium rates, financial analysis, and ... scores, and analyze impact. **KNOWLEDGE/SKILLS/ABILITIES** + Collaborate with Actuarial staff to calculate risk adjustment...+ Collaborate with Actuarial staff to calculate risk adjustment payment estimates. Document assumptions. +… more
- Elevance Health (FL)
- ** 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
- Humana (Louisville, KY)
- …claims or other healthcare data + Medicare risk adjustment experience + Financial or actuarial background **Additional Information** **Interview Format** ... trends and enhances modeling techniques. May possess financial or actuarial background. Understands department, segment, and organizational strategy and operating… more
- BlueCross BlueShield of North Carolina (NC)
- …9 years of relevant actuarial experience. **Bonus Points** + Experience in Medicare Advantage Risk Adjustment highly preferred **What You'll Get** + ... shaping the future of care delivery through data-driven insights and strategic actuarial expertise. You'll lead initiatives that directly impact patient outcomes and… 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
- Molina Healthcare (NY)
- …Analytics role will be responsible for work around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research, analysis ... complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data to evaluate healthcare...risk models including the various CMS models for Medicare Advantage members, the HHS model for Commercial ACA… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …data validation review. Prepares and submits adjustments to the appropriate processing / adjustment area ( Risk Adjustment / Actuarial Services). * Performs ... right for you, we encourage you to apply! Job Description: Summary: The Risk Adjustment Coding Coordinator is responsible for various aspects of decision-making… more
- Healthfirst (NY)
- …Product and Actuarial analytical requests. + Experience with CMS/HHS risk adjustment payment methodologies. + Self-motivated, creative problem solver who ... **Duties:** + Develop and maintain risk score forecasting models to assist Actuarial...+ At least 5 years previous work experience within risk adjustment + Credentialed Associate of the… 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
Recent Jobs
-
Penske - Warehouse Worker - Forklift Operator - 2nd Shift
- Penske Truck Leasing (Princeton, IN)
-
San Leandro Hospital Senior Physical Therapist, Per Diem, Varied shift, 8hours
- Alameda Health System (San Leandro, CA)
-
Director of Operations
- Legend Biotech USA, Inc. (Raritan, NJ)
-
Assoc. Dir., Engineering , Combination Products Platform Assembly and Packaging Technical Leadership
- Merck & Co. (Rahway, NJ)
Related Job Searches:
Actuarial,
Adjustment,
Medicare,
Medicare Risk Adjustment,
Risk,
Risk Adjustment