• Medicare Risk Adjustment…

    Elevance Health (Smithfield, RI)
    ​ ** Medicare Risk Adjustment Actuarial Analyst III** **On-Site Requirement: Hybrid 1;** **This role requires associates to be in-office 1 - 2 days per ... for employment, unless an accommodation is granted as required by law._ The ** Medicare Risk Adjustment Actuarial Analyst III** is responsible for… more
    Elevance Health (07/18/25)
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  • Lead Director, Medicare Actuarial…

    CVS Health (Providence, RI)
    …regulatory compliance. + Serve as a subject matter expert on CMS regulations, risk adjustment , and revenue optimization. + Collaborate with internal stakeholders ... CMS Part C/D operations. + 5+ years' experience working with CMS regulations, risk adjustment methodologies, and revenue management. + 5+ years' experience… more
    CVS Health (07/01/25)
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  • Medicare Risk Adjustment…

    Elevance Health (Smithfield, RI)
    ** Medicare Risk Adjustment Advanced Analytics Consultant** **On-Site Requirement: Hybrid 1;** **This role requires associates to be in-office 1 - 2 days per ... an accommodation is granted as required by law._ The ** Medicare Risk Adjustment Advanced Analytics...writing errors and rework. + Assists in training of actuarial trainees, analysts, and specialists. + Consults on all… more
    Elevance Health (07/29/25)
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  • Provider Engagement Analyst, VBP ( Medicare…

    Centene Corporation (Providence, RI)
    … Medicare contract models, incorporating CMS and NYSDOH guidelines related to risk adjustment , quality metrics, and financial benchmarks. + Collaborate with ... management and Service Fund teams to implement monitoring of Medicare -specific VBP contracts, including models with upside/downside risk...internal teams (eg, Actuarial , Clinical, Legal, and Provider Relations) to align on… more
    Centene Corporation (07/23/25)
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  • Sr Analyst, Specialty Performance Analytics

    Evolent (Providence, RI)
    …of Medicare claims, episode and condition groupers, case/episode and risk adjustment , patient attribution methodologies, and network analysis and pod ... + Bachelor's degree, preferably with a quantitative major (eg actuarial , statistics, biostatistics, operations research, mathematics, economics) or healthcare major… more
    Evolent (05/22/25)
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