- Highmark Health (Blue Bell, PA)
- …to identify both opportunities and weaknesses in the government's actuarial risk score models to inform better business decisions 4. Operations and ... Development and Management: + Provide strategic leadership and management for the Risk Adjustment Accuracy Management Department. + Develop and oversee programs… 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 ... Health Plan strategic analysis and planning and coordinates across business units on Risk Adjustment ... to provide analytic support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …data validation review. Prepares and submits adjustments to the appropriate processing / adjustment area ( Risk Adjustment / Actuarial Services). * Performs ... opportunities to the team. * Serves as a coordinator and key business resource for the Risk Adjustment Coding Coordination Team. * Conducts reviews and… more
- Molina Healthcare (Grand Island, NE)
- …**Job Summary** This Sr. Analyst, Healthcare Analytics role will support Molina's Risk Adjustment Analytics team. The job responsibilities include developing ... + Experience developing queries within project management tools like Azure DevOps. + Risk Adjustment experience and some familiarity with Power BI level report… more
- The Cigna Group (Houston, TX)
- …with medical claims data (CPT/ICD10) + Experience with HHS ACA (or Medicare) risk adjustment models; Healthcare Actuarial Modeling or financial modeling ... & Family Plans (IFP) is a fast-paced Cigna Healthcare business unit serving the Affordable Care Act (ACA) market....IFP Analytics team responsible for identifying and sizing new risk adjustment opportunities that not only create… 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
- New York State Civil Service (Albany, NY)
- …order to be eligible for appointment.Non-Competitive: A Bachelor's Degree in Accounting, Actuarial Science, Auditing, Banking, Business , Business and ... Blockchain Analytics Analyst (Financial Services Specialist 2 (Financial Crimes Risk ), SG-23) Occupational Category Financial, Accounting, Auditing Salary Grade 23… more
- New York State Civil Service (Albany, NY)
- …to be eligible for appointment.Non-Competitive: A Bachelor's Degree in accounting, actuarial sciences, auditing, banking, business , business administration, ... HELP No Agency Financial Services, Department of Title Financial Crimes Risk Manager (Director Financial Services Programs 1, SG-31) Occupational Category Financial,… more
- New York State Civil Service (New York, NY)
- …Opinion ("SAO"), Actuarial Opinion Summary ("AOS") reviews, loss and loss adjustment expense reserves analysis; solvency reviews (eg, RBC calculations), risk ... data reconciliations and other related examination tasks requiring knowledge of the actuarial functions;* Reviews Own Risk and Solvency Assessment ("ORSA")… more
- State of Connecticut, Department of Administrative Services (Hartford, CT)
- …Actuary Supervisor, and Chief Insurance Actuary: + Analyze insurance data and perform actuarial calculations to determine risk and pricing for various insurance ... team of dedicated professionals to analyze insurance data, assess risk , and make critical recommendations. Your expertise will help...and rate filings + Assist in developing and maintaining actuarial models and tools to support business … more