- Allianz (New York, NY)
- We are looking for a Complex Claims Analyst - Management Liability (m/f/d), based in our New York City office. Your Team You will be working with a small but diverse ... and materials as appropriate; and Supporting the establishment of claims management procedures on new business accounts in association with clients, brokers… more
- HealthCare Partners (Garden City, NY)
- …by working in close partnership with the Customer Engagement Center (CEC), Pharmacy, Risk Adjustment , Utilization Management , Quality, Network Relations, and ... with internal teams to ensure accurate understanding and achievement of quality and risk adjustment metrics. Serves as a quality resource for providers and… more
- StateJobsNY (New York, NY)
- …Opinion ("SAO"), Actuarial Opinion Summary ("AOS") reviews, loss and loss adjustment expense reserves analysis; solvency reviews (eg, RBC calculations), risk ... *Supervises subordinate actuarial staff; establishes goals and priorities, monitors performance , and completes performance evaluations; *Provides technical… more
- EmblemHealth (New York, NY)
- …the appropriate regulatory authority (eg, CMS, New York Dep't of Health). Work closely with Risk Adjustment and other areas to optimize risk adjustment ... support the activities of the affiliates. Responsibilities: Work closely with Senior Product Management and Finance to analyze financial performance of blocks of… more
- Molina Healthcare (Syracuse, NY)
- …Risk Adjustment submissions data to evaluate healthcare intervention program performance . Develops and presents Risk Adjustment intervention ROI, ... Services (SSIS), and other analytic / programming tools as needed + Reporting includes Risk Adjustment program performance metrics, risk score and… more
- Elevance Health (New Hyde Park, NY)
- …historical program performance and to inform current operating decisions. + Prepares management reports for risk adjustment related projects. + Collects ... **Medicare Risk Adjustment Actuarial Analyst III** **On-Site Requirement: Hybrid 1;** **This role requires associates to be in-office 1 - 2 days per week,**… more
- Datavant (Albany, NY)
- …to realize our bold vision for healthcare. **Role Overview** As a Product Manager, Risk Adjustment Analytics Products, you will contribute to the strategy and ... execution of analytics capabilities that power Datavant's risk adjustment solutions. You'll drive the development of robust, scalable, and actionable analytics… more
- Datavant (Albany, NY)
- …planning and management of workloads, communication with stakeholders, and the risk adjustment subject matter expertise necessary to be operating proactively ... vision for healthcare. **What we're looking for:** The incoming Risk Adjustment Analytics Manager will be stepping...analytics + Experience using Jira for workflow and project management + Experience using both Microsoft and Google office… more
- Ankura (New York, NY)
- …college/university + Current Registered Nurse license + Experience working for payors conducting risk adjustment reviews + Clinical experience in a variety of ... solutions to help clients at critical inflection points related to conflict, crisis, performance , risk , strategy, and transformation. The Ankura team consists of… more
- Datavant (Albany, NY)
- …strategic mindset and a focus on continuous improvement. + Familiarity with CMS HCC risk adjustment processes preferred \#LI-BC1 We are committed to building a ... to escalate and create solutions. + Own client operations project management processes, tools, reference materials, and cross‐functional usage. + Identify, define,… more
