- Elevance Health (Chicago, IL)
- …may be considered. The Director & Actuary II is responsible for directing actuarial research required to identify and solve actuarial problems for a region. ... Anticipated End Date: 2025-07-19 Position Title: Director & Actuary II Job Description: Director...actuarial data delivery and support. Conducts experience analysis. Lead evolution of network analysis and total-cost-of-care measurement and… more
- EmblemHealth (New York, NY)
- …staff to facilitate standard reporting and ad hoc analysis. Perform/ lead root cause analysis exercises to identify potential recovery/avoidance opportunities ... from problems due to undiscovered system or other issues. Lead projects focused on care management, disease management and quality management optimization, working… more
- CVS Health (Boston, MA)
- …strategies, and supporting Medicare operations through advanced analytics and actuarial insights. Key Responsibilities: + Lead the development and execution ... We are seeking a strategic and technically proficient leader to oversee Medicare data science initiatives supporting actuarial analytics and pricing. The… more
- Marshfield Clinic (Marshfield, WI)
- …together to support the most exciting missions in the world!** **Job Title:** Director of Actuarial and Risk Adjustment Services **Cost Center:** 682891378 SHP- ... (United States of America) **Job Description:** **JOB SUMMARY** The Director of Actuarial & Risk Adjustment Services...Risk Adjustment Services partners with the Chief Actuary to lead unit development and execution of strategy through tactics,… more
- Centene Corporation (Queens, NY)
- …(VBP) will lead and support the expansion and optimization of Medicare -focused VBP arrangements across New York. This role is critical in managing end-to-end ... position will be responsible for working with the VBP Director , other VBP Managers, and Analysts, as well as...as upside/downside risk, shared savings, and global capitation. + Lead a team of analysts responsible for Medicare… more
- WelbeHealth (Los Angeles, CA)
- …vulnerable seniors with better quality and compassion in a value-based model. The Director , Actuary is accountable for all actuarial functions related to PACE ... underwriting, product development, and executive leadership to drive strategic initiatives + Lead full scale actuarial projects and project teams, as well… more
- Humana (Hartford, CT)
- …through deep knowledge of pharmacy trends, taking into account regulatory changes in the Medicare Part D space + Work with actuarial team to understand impact ... share, and abandonment rates + Work collaboratively with cross-functional teams, including marketing, actuarial , and finance + Develop and lead a team of both… more
- Elevance Health (Waukesha, WI)
- …promoting a dynamic and adaptable workplace. Alternate locations may be considered. The ** Director II, Provider Economics** , will lead strategic analytics and ... ** Director II Provider Economics - Value-Based Specialty Care**...support the design of new provider reimbursement methodologies across Medicare , Medicaid, and Commercial lines of business. * Measure… more
- CareFirst (Baltimore, MD)
- …day-to-day operations, performance, and oversight of pharmacy economics and PBM functions. The Director will lead and oversee ongoing day-to-day functions of the ... delivery. **ESSENTIAL FUNCTIONS:** Supply Chain and Contracts & Vendor Management: o Lead the operating model for pharmacy rebates and network discounts and PBM… more
- AbbVie (Mettawa, IL)
- …love for you to join us. The individual hired as the Associate Director , Payer Contract Analytics, within the Market Analytics and Business Insights (MABI) ... organization will lead the financial assessment of payer contracting via data...+ Support all channels of payer contracting including Commercial, Medicare Part D, Medicaid and other Government channels +… more
- Prime Therapeutics (Providence, RI)
- …key stakeholders, senior management, and clients; answer detailed and challenging questions regarding actuarial data + Lead and mentor Actuarial team members ... The Principal Actuary is responsible for supporting the development of actuarial concepts and providing thought leadership for Prime's existing and potential… more
- Datavant (Little Rock, AR)
- …and external stakeholders. The manager will collaborate with other managers and the department director to set strategy and mobilize the team to be as performant as ... team. **What you will do** : + Set and lead the day-to-day work of their direct reports with...their direct reports with guidance and collaboration from the director and other department managers + Develop core relationships… more
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