- CVS Health (New York, NY)
- …regulatory compliance. Serve as a subject matter expert on CMS regulations, risk adjustment , and revenue optimization. Collaborate with internal stakeholders to ... CMS Part C/D operations. 5+ years' experience working with CMS regulations, risk adjustment methodologies, and revenue management. 5+ years' experience leading… more
- Selby Jennings (New York, NY)
- …performance Lead the development and filing of premium rates Collaborate with Risk Adjustment and other cross-functional teams to identify opportunities for ... insurers is seeking a Senior Actuary to join its Medicare team. This is a great opportunity for someone...product improvement Provide leadership and mentorship to actuarial staff as needed Qualifications: Bachelor's degree in … more
- Horizon Blue Cross Blue Shield of New Jersey (Newark, NJ)
- …with Enterprise Resource Planning (ERP) systems (Workday). Experience with Billing/Purchasing/Procurement. Medicare , Medicaid, or commercial risk adjustment ... agreements. Assess the quality, timeliness, and completion of incoming data from risk adjustment vendors and calculate financial penalties based on contractual… more
- Elevance Health (Woodbridge, NJ)
- ** 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
