- Somatus (Mclean, VA)
- …strategies to position the company for a successful IPO. + **Collaborate** with Actuary and MedEcon to structure pricing and contract terms for profitability ... health regulations, bonus methodologies, and financial structures across Medicare, Medicaid , and commercial payers. + **A clear communicator and collaborative… more
- Humana (Columbus, OH)
- …team in identification of cost drivers, utilization patterns, and anomalies in Medicaid medical claims data. The Actuary , Analytics/Forecasting ensures data ... and help us put health first** Own and manage Medicaid claims analytics dataset using Databricks. Ensure data accuracy,...+ Experience in more than two functions (eg, modeling, pricing , rate filing, reporting & analysis, reserving or trending)… more
- Humana (Jackson, MS)
- …part of our caring community and help us put health first** The Actuary , Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide ... organization's short, medium and long-term financial and competitive position. The Actuary , Analytics/Forecasting works on problems of diverse scope and complexity… more
- Prime Therapeutics (Indianapolis, IN)
- …of actuarial work experience in a healthcare organization or PBM + Previous experience pricing Commercial, Medicare or Medicaid lines of businesses + 5 years of ... career? Come build the future of pharmacy with us. **Job Posting Title** Principal Actuary - REMOTE **Job Description** The Principal Actuary is responsible for… more
- Humana (Honolulu, HI)
- …part of our caring community and help us put health first** The Actuary , Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide ... organization's short, medium and long-term financial and competitive position. The Actuary , Analytics/Forecasting works on problems of diverse scope and complexity… more
- Humana (Washington, DC)
- …part of our caring community and help us put health first** The Actuary , Analytics/Forecasting analyzes and forecasts financial, economic, and other data to provide ... organization's short, medium and long-term financial and competitive position. The Actuary , Analytics/Forecasting works on problems of diverse scope and complexity… more
- Humana (Boise, ID)
- …part of our caring community and help us put health first** The Lead Actuary , Risk and Compliance is responsible for the overall management and oversight of ... and recommends controls and cost-effective approaches to minimize risks. The Lead Actuary , Risk and Compliance works on problems of diverse scope and complexity… more
- State of Minnesota (St. Paul, MN)
- **Working Title: Chief Health Actuary ** **Job Class: Director Actuarial and Regional Policy Analyst** **Agency: Commerce Department** + **Job ID** : 90317 + ... and MEWAs. Assist other agencies in technical calculations used to collect Medicaid surcharge taxes, which provides approximately $39 million of revenue to the… more
- Banner Health (Phoenix, AZ)
- …organizations to coordinate rate filings and year-end financials. Is responsible for all pricing , rate development and filings for all products. This role will also ... analyzing, developing, and/or submitting Medicare Advantage and Prescription Drug plan bid pricing tools and/or plan benefit packages. This role will ensure the… more
- Sutter Health (Sacramento, CA)
- …Provides guidance on a range of topics such as utilization, product pricing including benefit design, contracting, premium revenue, and trend forecasting. Monitors ... (MAAA) preferred **SKILLS AND KNOWLEDGE:** + Expertise in actuarial pricing , underwriting, statistical modeling, analytics, networks, forecasting and reserve… more
- CVS Health (Blue Bell, PA)
- …and Aetna is aggressively expanding into this market. This position provides an ambitious actuary the opportunity to get into a growth story early, work closely with ... all of the above effectively. Coordinating the analytics, reporting, and pricing /bidding best practices of Aetna's SNP segment, across all Aetna geographies,… more
- CVS Health (Columbus, OH)
- …guidance to the health plan and external partners for the state Managed Medicaid pharmacy benefit. The Pharmacy Director reports to the Senior Lead Pharmacy Director ... and regulations pertaining to both pharmacy practice laws and Managed Medicaid /PBM regulations. The Pharmacy Director stays updated on changing regulations,… more
- Elevance Health (Grand Prairie, TX)
- …close collaboration with cross-functional partners-including Clinical Pharmacy, Formulary, Actuary , Pricing /Underwriting, and other key business leaders. ... therapeutic options leveraging clinical and analytic data for Commercial, Medicare, and Medicaid lines of business. + Refine model estimates based on real-time… more
