• Actuary - Value - Based…

    Humana (Harrisburg, PA)
    **Become a part of our caring community and help us put health first** The Value - Based Care Infrastructure Actuary will play a crucial role in supporting ... cross-functional teams to ensure that the infrastructure aligns with organizational goals in value - based care The Actuary ensures data integrity by… more
    Humana (05/03/25)
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  • Principal Actuary - REMOTE

    Prime Therapeutics (Harrisburg, PA)
    …our passion and drives every decision we make. **Job Posting Title** Principal Actuary - REMOTE **Job Description** The Principal Actuary is responsible for ... owners and clients. This position will collaborate with the Senior Principal Actuary to provide strategic consulting support, manage the development of innovative… more
    Prime Therapeutics (03/28/25)
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  • Actuary - Network Performance & Execution

    CVS Health (Blue Bell, PA)
    …focus include network discounts, Accountable Care Organizations (ACOs), and other Value Based Contracts (VBCs). **Network Actuary key responsibilities ... ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions… more
    CVS Health (04/20/25)
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  • Actuary

    UPMC (Pittsburgh, PA)
    …Global Capitation, Bundled Rates, Episodic Payments, Capitation, Risk Adjusted Total Cost of Care , and Value Based Payments. Build credibility and trust, ... Capitation, Bundled Rates, Episodic Payments, Capitation, Risk Adjusted Total Cost of Care , and Value Based Payments. + Build credibility and trust, enhance… more
    UPMC (04/18/25)
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  • Actuary - Medical Pharmacy

    CVS Health (Blue Bell, PA)
    …ourselves with dedicated colleagues who are passionate about transforming health care . As the nation's leading health solutions company, we reach millions ... project management/organizational skills to stand up a formal cadence to value and review initiatives and communicate succinctly to cross-functional workgroups +… more
    CVS Health (04/23/25)
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  • Provider Contracting Senior Manager, National…

    CVS Health (Harrisburg, PA)
    …care in contracting, provider relations, provider operations and/or solutions. . Experience in Value Based Care financial models. . Experience in Risk- ... . Serve as a liaison among internal customers, operations, actuary , product, and analytic teams to ensure reimbursement initiatives...based arrangements and Value - Based care in government services… more
    CVS Health (04/17/25)
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  • Director Reimbursement Design & Market Evaluation

    Highmark Health (Harrisburg, PA)
    …the current health care delivery state, readiness for change, test value based programming concepts and components, identify key partners, identify and ... years Healthcare, Healthcare Insurance, Consulting or related area + 3 years Value - based reimbursement, through managed care contracting, provider… more
    Highmark Health (03/04/25)
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  • Market Director - (SEPA Market)

    Highmark Health (Blue Bell, PA)
    …years of experience in the health care /health insurance industry to include value - based care and provider relations/network management + Experience with ... The incumbent is responsible for engaging entities on performance-related activities such as Value - Based Reimbursement (VBR), Stars and Risk capture, as well as… more
    Highmark Health (03/13/25)
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  • Corporate Director Network Strategy

    AmeriHealth Caritas (Newtown Square, PA)
    Your career starts now. We're looking for the next generation of health care leaders. At AmeriHealth Caritas, we're passionate about helping people get care , ... communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to...strategy function, with a focus on optimizing total network value . The Corporate Director, Network Strategy is tasked with… more
    AmeriHealth Caritas (04/23/25)
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  • Manager Strategic Risk Adjustment Programs

    Highmark Health (Harrisburg, PA)
    …support to new and existing Risk Adjustment Programs. The incumbent will deliver value to the Health Plan, and its beneficiaries enrolled in Risk Adjusted government ... Programs. Supports other key objectives designed to build/strengthen patient care delivery and capture of Risk Adjustment documentation/ reporting capabilities,… more
    Highmark Health (03/06/25)
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