- Molina Healthcare (Bowling Green, KY)
- …**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 (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)
- …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
- CVS Health (Blue Bell, PA)
- …the operational and financial performance evaluation across Aetna's Commercial and Medicaid Care Management programs to optimize the programs' performance, identify ... for building and maintaining staffing models that support the Commercial and Medicaid Care Management programs. Key responsibilities of this role include: + Build… 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
- Centene Corporation (Sacramento, CA)
- …we're seeking a finance professional with strong **FP&A** expertise with ** Medicaid industry experience** to deliver strategic insights and drive operational ... and financial performance tracking. + Collaborate cross-functionally with product, actuarial , and operational teams to improve forecast accuracy and business… more
- Molina Healthcare (New York, NY)
- **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
- AbbVie (Mettawa, IL)
- …businesses such as the Commercial Insurance channel, Medicare and Medicaid Channels. This role requires collaboration with stakeholders including Finance, ... Qualifications + Bachelor's degree or foreign academic equivalent in Statistics, Economics, Actuarial Science, Business Analytics or a highly related field of study,… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Data Science Analyst III is a senior role, collaborating with stakeholders from across the organization to develop sophisticated ... decision-making, goal setting, and effective performance measurement. The Data Science Analyst III demonstrates sound and a more advanced understanding of the… more
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