- CVS Health (Springfield, IL)
- …partners in addition to the broader actuarial team. **A Brief Overview** Senior Analysts on the Medicare Actuarial team leverage strong technical ... Health's financial integrity with sound pricing and risk management practices. The Medicare Actuarial Pricing team is responsible for anticipating and… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Medicare Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and ... of any changes to the HCC model and supporting actuarial in the calculation risk adjustment revenue. + Assists...the Division. + Ability to work with and support Senior Management and to disseminate and summarize information into… more
- Blue Cross and Blue Shield of Louisiana (Baton Rouge, LA)
- …Technology staff, Benefits Administration staff, Provider Audit, Network Administration and/or Medicare Advantage staff, and entry level Reimbursement Analyst by ... for internal and external use. Designated staff may focus primarily on supporting the Medicare Advantage line of business. **NATURE AND SCOPE** + This role does not… more
- Molina Healthcare (Miami, FL)
- **Job Description** **Job Summary** Sr . Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation ... rate proposals. * Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of reimbursement changes, educate/consult… more
- Molina Healthcare (Scottsdale, AZ)
- **Job Description** **Job Summary** Sr . Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation ... rate proposals. + Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of reimbursement changes, educate/consult… more
- Martin's Point Health Care (Portland, ME)
- …been certified as a "Great Place to Work" since 2015. Position Summary The Senior Medical Economics Analyst - Pharmacy is responsible for performing advanced ... support pharmacy benefit design, formulary management, and value-based initiatives. The analyst partners closely with pharmacy, actuarial , clinical, and finance… more
- Centene Corporation (Jefferson City, MO)
- …Purpose:** Drives analytics and insights related to Medicaid, Marketplace, or Medicare programs with the objective of driving consumer acquisition and retention. ... **Education/Experience:** **Bachelor's Degree or equivalent in Business Administration, Marketing, Actuarial Sciences, Applied Mathematics or Statistics required** **:** 5+… more
- AbbVie (Mettawa, IL)
- …channels of pharmaceutical businesses such as the Commercial Insurance channel, Medicare and Medicaid Channels. This role requires collaboration with stakeholders ... Qualifications + Bachelor's degree or foreign academic equivalent in Statistics, Economics, Actuarial Science, Business Analytics or a highly related field of study,… more
- Mount Sinai Health System (New York, NY)
- **Job Description** The Data Science Analyst III is a senior role, collaborating with stakeholders from across the organization to develop sophisticated ... decision-making, goal setting, and effective performance measurement. The Data Science Analyst III demonstrates sound and a more advanced understanding of the… more
- Geisinger (Danville, PA)
- Job Summary Provides application support to the Commercial Sales and Medicare division including the Call Center staff. Provides reporting and data analysis, as ... appropriate, in order to support Commercial and Medicare Sales in addition to Sales and Marketing Management....departments specific to data retrieval, analysis and reporting, eg Actuarial Support and QI. + Works with Commercial and… more
- Humana (Louisville, KY)
- …and NCQA accreditations). The leader may be a data scientist, financial analyst , economist, or other analytical professional; though experience in Medicaid or ... scorecards and financial metrics to optimize segment outcomes. + Collaborate with actuarial , finance, and clinical teams to interpret data and inform executive… more