- Fallon Health (Worcester, MA)
- …be the leading provider of government-sponsored health insurance programs-including Medicare, Medicaid , and PACE (Program of All-Inclusive Care for the Elderly)- in ... **Brief Summary of Purpose:** Seeking a motivated and detail-oriented analyst to join our team. This position is ideal...ideal for candidates who have passed at least two actuarial exams and are eager to apply their analytical… more
- Humana (Lincoln, NE)
- …a part of our caring community and help us put health first** The Actuarial Analyst 2, Pricing is responsible for supporting the implementation of rates, ... pricing tools that price standard and custom benefits. The Actuarial Analyst 2, Pricing work assignments are...a better quality of life for people with Medicare, Medicaid , families, individuals, military service personnel, and communities at… more
- Molina Healthcare (Davenport, IA)
- …**Job Summary** Responsible for being the SME (Subject Matter Expert) for Medicaid risk adjustment programs in multiple states. Maintain risk adjustment model, ... available to lead national risk adjustment studies. Prior experience in Medicaid risk adjustment is not required. **KNOWLEDGE/SKILLS/ABILITIES** + Analyze risk score… more
- Humana (Baton Rouge, LA)
- …Senior Market Finance Professional supports more than half of Humana's Medicaid business, providing technical financial analysis and data-driven insights to drive ... with Market CFOs, clinical teams, and provider engagement teams, focusing on Medicaid claims and premium analytics across multiple states, including established and… more
- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Medicaid Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and ... coordination of analytical processes, investigation and interpretation of Maryland Medicaid risk score methodology, risk score calculation, submissions, enrollment,… more
- Humana (Nashville, TN)
- …caring community and help us put health first** The Vice President, Medicaid Clinical Economics & Quality provides strategic and operational leadership for clinical ... effectiveness within the Medicaid segment. This function integrates Medical Economics, Clinical Insights,...accreditations). The leader may be a data scientist, financial analyst , economist, or other analytical professional; though experience in… 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 analytics to ... decision-making, goal setting, and effective performance measurement. The Data Science Analyst III demonstrates sound and a more advanced understanding of the… more
- Molina Healthcare (New York, NY)
- **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and ... and future contract rate proposals. + Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of reimbursement changes,… more
- Molina Healthcare (NM)
- **Job Description** **Job Summary** Sr. Analyst , Network Strategy, Pricing & Analytics guides the investment of our network partners through contract valuation and ... and future contract rate proposals. * Research, analyze, and consult Medicaid and Medicare reimbursement methodologies, evaluate the impact of reimbursement changes,… more
- Centene Corporation (Jefferson City, MO)
- …workplace flexibility. **Position Purpose:** Drives analytics and insights related to Medicaid , Marketplace, or Medicare programs with the objective of driving ... **Education/Experience:** **Bachelor's Degree or equivalent in Business Administration, Marketing, Actuarial Sciences, Applied Mathematics or Statistics required** **:** 5+… more
- AbbVie (Mettawa, IL)
- …businesses such as the Commercial Insurance channel, Medicare and Medicaid Channels. This role requires collaboration with stakeholders including Finance, ... Qualifications + Bachelor's degree or foreign academic equivalent in Statistics, Economics, Actuarial Science, Business Analytics or a highly related field of study,… more
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