- Point32Health (Boston, MA)
- …at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** This Senior Actuarial Analyst will support the Medicare Part C Pricing work. ... The key responsibilities for this role are pricing, rate filing ( Medicare Advantage Bid) development, strategic analysis, and other ad hoc projects. This role will… more
- Point32Health (Canton, MA)
- …we are at Point32Health, click here (https://youtu.be/S5I\_HgoecJQ) . **Job Summary** The Senior Manager of Product Implementation and Administration will have ... and related filings, new benefit implementation, and product/vendor management processes. The Senior Manager will support annual assessment of new product… more
- The Cigna Group (Denver, CO)
- The Medical Claims FP&A Senior Manager will manage projection and results analysis for core Medicare Advantage Part C medical claims expense processed and ... is expected to be the largest focus for the manager in the medium and long term. This individual...Given the close partnership between this team and the Actuarial Pricing and Reserving teams, an actuarial … more
- Travelers Insurance Company (Downers Grove, IL)
- …Coordinate medical and indemnity position of the claim with a Medical Case Manager . Independently handles assigned claims of low to moderate complexity where Wage ... to reflect claim exposure and document rationale. Identify and set actuarial reserves. Apply knowledge to determine causal relatedness of medical conditions.… more
- CVS Health (Overland Park, KS)
- …all four of Aetna's major lines of business (Commercial Group, Commercial Individual, Medicare Advantage, and Medicaid). This position will support a wide range of ... stakeholders, including Aetna/CVS Health Executive Leadership Teams, Finance, Actuarial , Network, Underwriting, Investor Relations, and Corporate Planning. The… more
- LA Care Health Plan (Los Angeles, CA)
- …quality improvement programs. Analytics experience with Medicare Advantage, Medicare Fee-For-Service (FFS), Multipurpose Senior Services Program (MSSP) and ... Manager , Analytics Job Category: Accounting/Finance Department: Risk Adjustment...care claims Knowledge of Risk Adjustment models (eg CMS Medicare Advantage, HHS-HCC, Medicaid DxCG) Extensive knowledge of healthcare… more
- BrightSpring Health Services (Louisville, KY)
- …support the Medicare Advantage Institutional Special Needs Plan (I-SNP), the Manager will work in collaboration with all clinical and operations staff on varying ... Medical Services company, Population Health Management services company, and a Medicare Advantage Institutional Special Needs Plan (I-SNP).Under the direction of the… more
- MarketSource (Alpharetta, GA)
- 121666BRTitle:Compliance ManagerJob Description: Compliance Manager (Insurance) MarketSource Inc., an Allegis Group Company, develops and delivers innovative managed ... and lead the insurance compliance management strategy for the organization's Medicare Advantage sales program including carrier compliance, and multi-carrier *… more
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