- Elevance Health (Waukesha, WI)
- ** 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
- Marshfield Clinic (Marshfield, WI)
- …to support the most exciting missions in the world!** **Job Title:** Director of Actuarial and Risk Adjustment Services **Cost Center:** 682891378 SHP- ... of America) **Job Description:** **JOB SUMMARY** The Director of Actuarial & Risk Adjustment Services...excluded from participation in any federally funded program, including Medicare and Medicaid. This is a condition of employment.… more
- CVS Health (Madison, WI)
- …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
- Molina Healthcare (Racine, WI)
- …Analytics role will be responsible for work around Program Valuation on Molina's Risk Adjustment Actuarial team. Responsibilities include research, analysis ... complex healthcare claims data, pharmacy data, lab data, and Risk Adjustment submissions data to evaluate healthcare...risk models including the various CMS models for Medicare Advantage members, the HHS model for Commercial ACA… more
- Datavant (Madison, WI)
- …and managing in a remote environment (2+ years) + 3+ years of experience working with Medicare , ACA, and/or Medicaid risk adjustment models + 5+ years of ... to realize our bold vision for healthcare. **What we're looking for:** The incoming Risk Adjustment Analytics Manager will be stepping into a role on the… more
- Evolent (Madison, WI)
- …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
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