- Elevance Health (Mendota Heights, MN)
- ** Medicare Risk Adjustment Actuarial Analyst III** **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 Actuarial Analyst ...complex projects related to risk adjustment analytics in the Medicare Advantage line of business. **How You… more
- Blue Cross Blue Shield of Massachusetts (Boston, MA)
- …+ Solid understanding of Medicare and its related financial models, including Medicare FFS, Medicare Advantage , Medicare Part D, and ... member of the senior markets pricing team, within the Actuarial & Analytic Services department. This role provides the...BCBSMA, with a focus on senior product strategy and Medicare Markets. This candidate must be a creative thinker… more
- Humana (San Juan, PR)
- …part of our caring community and help us put health first** The Actuarial Analyst 2, Analytics/Forecasting analyzes and forecasts financial, economic, and other ... the organization's short, medium and long-term financial and competitive position. The Actuarial Analyst 2, Analytics/Forecasting work assignments are varied and… more
- UPMC (Pittsburgh, PA)
- …of topics affecting the financial performance of the health plan; assist with reconciling Medicare Advantage Part C and Part D claims data to financials; analyze ... changes; develop assumptions, project costs and monitor emerging experience of Medicare Advantage Mandatory Supplemental Benefits including, but not limited… more
- Centene Corporation (Providence, RI)
- …and performance of Medicare -focused VBP arrangements across New York, including Medicare Advantage and Dual Eligible Special Needs Plans (D-SNPs). This role ... in transforming healthcare to improve outcomes, advance quality, and promote equity. The Analyst , Value-Based Payment Initiatives (VBP) will support the expansion… more
- Molina Healthcare (Roswell, NM)
- …proficiency in running all applicable risk models including the various CMS models for Medicare Advantage members, the HHS model for Commercial ACA members, the ... trends in risk adjustment to provide analytic support for finance, pricing and actuarial functions + Healthcare Analyst I or Financial/Accounting Analyst … more
- Molina Healthcare (GA)
- **Job Description** **Job Summary** The Analyst , Risk Adjustment-Predictive Analytics role will support Molina's Risk Adjustment Predictive Analytics team. Designs ... modules related to Risk Adjustment for Medicaid, Marketplace and Medicare /MMP. + Assist Risk Adjustment Data Analytics Leaders in...like Python and R programming would be an added advantage . + 1-3 Years of experience in Analysis related… more
- AmeriHealth Caritas (Newtown Square, PA)
- …/ ROI data. + Oversee CAHPS and Stars analytics and improvement strategies for Medicare Advantage . + Ensure readiness for NCQA accreditation and other quality ... Quality Performance Reporting & Analytics and Risk Adjustment for Medicaid Quality, Medicare Stars, and Exchange QRS. This leader is accountable for driving strategy… more