- The Cigna Group (Bloomfield, CT)
- The National Value - Based Partnerships Senior Analyst position is an integral member of the National Partnerships team and will be responsible for ... in class end-to-end administration of contract operations for Cigna Medicare 's most advanced value - based provider...stakeholders. **Where You'll Focus Your Time:** + Support complex value - based negotiations for national provider… more
- The Cigna Group (Bloomfield, CT)
- …the analytics strategy for Cigna Healthcare, performing research and analysis within the Medicare Stars program with a focus on HEDIS Stars measures. This position ... is located within the Medicare Stars Analytics team, who's function is to provide...clinical outcomes and Stars quality measures to make recommendations based on relevant findings. The Business Analytics Advisor will… more
- The Cigna Group (Bloomfield, CT)
- …direction of assigned markets and is accountable for the management of value - based and fee-for-service contracting and network management activities for multiple ... Manages increasingly complex contracts and negotiations for fee-for-service and sophisticated value - based reimbursements with hospitals and other providers for… more
- CVS Health (Hartford, CT)
- …but not limited to, risk adjusted revenue, SAIs & mitigation items, value - based contract arrangements, provider liabilities, utilization, and provider unit cost ... not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual… more
- The Cigna Group (Bloomfield, CT)
- …and strong commitment to client service a must + Knowledge of PBM industry/Managed care/ Value Based healthcare industry is desirable If you will be working at ... orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status… more
- Humana (Hartford, CT)
- …with Azure Synapse Analytics + Proficient in understanding Healthcare related data + Medicare and/or Value Based knowledge **Additional Information** Work at ... help us put health first** The Service Fund Senior Value - Based Programs Analyst supports our Market and...to a better quality of life for people with Medicare , Medicaid, families, individuals, military service personnel, and communities… more
- Highmark Health (Hartford, CT)
- …to understand the current health care delivery state, readiness for change, test value based programming concepts and components, identify key partners, identify ... models that support enterprise strategic initiatives that might fall outside of planned value - based reimbursement designs and/or to serve as a focus of… more
- CVS Health (Hartford, CT)
- … care contracting/negotiations. + Experience in Risk- based arrangements and Value - Based care in government services ( Medicare Advantage, Medicaid, ... market and to support segment leaders with growing our value based care portfolio. You will make...in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin,… more
- Humana (Hartford, CT)
- …with clinicians and support staff to provide Humana members with optimal value based care in accordance with Medicare and Humana policy. All work occurs ... diverse resources, included but not limited to CMS policies, National and Local Coverage Determinations, CMS-recognized Compendia, NCCN, Humana...as determined necessary to support optimal value based care in accordance with Medicare and… more
- Humana (Hartford, CT)
- …is a role within the Senior Products Actuarial Compliance team focused on special Medicare Advantage programs, including Value Based Insurance Design (VBID), ... science. Advises certifying actuaries, executives, and non-actuarial business partners on Value Based Insurance Designs (VBIDs), Special Supplemental Benefits… more
- Humana (Hartford, CT)
- …high degree of integrity, professionalism, resourcefulness, and enjoy working in a team- based environment. Medical Directors support Humana value throughout all ... and work is assisted by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal… more
- Humana (Hartford, CT)
- …of Humana processes, as well as a focus on collaborative business relationships, value based care, population health, or disease or care management. Medical ... and work is assisted by diverse resources, which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal… more
- Humana (Hartford, CT)
- …of Humana processes, as well as a focus on collaborative business relationships, value based care, population health, or disease or care management. Medical ... and work is assisted by diverse resources which may include national clinical guidelines, CMS policies and determinations, clinical reference materials, internal… more
- CVS Health (Hartford, CT)
- …and risks, through key root-cause analyses, and manage the risk position of various value - based products ( Medicare Advantage, MSSP, ACO REACH).** **What will ... Limited Data Set (5% Sample Data) Prior Experience in Value - based care settings Proficient in Excel, Work...in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin,… more
- Humana (Hartford, CT)
- …impact on underwriting margin. They will work collaboratively with peers across Medicare Risk Adjustment, Membership Growth Analytics, Medicare Finance, and ... claims. They will establish or improve upon processes to value movement from plan to plan (P2P), changes in...perform ad hoc analytics on member cohorts of interest based on emerging experience and trend drivers, and present… more
- CVS Health (Hartford, CT)
- …drivers and develop strategic options and opportunities to favorably impact performance of our Medicare Value Based Contracts. + Partners and consults with ... analytical ability and problem-solver mentality **Preferred Qualifications** Prior experience in Value Based Care. **Education** Bachelor's degree or equivalent… more
- CVS Health (Hartford, CT)
- …track record of sales success, leadership experience and a strong knowledge of Medicare Advantage and value - based care programs. + Extensive healthcare ... role have an impact?** CVS Accountable Care is committed to growing our value - based care footprint and supporting providers and payers in successfully delivering… more
- Deloitte (Hartford, CT)
- …with product design and/or product strategy + Experience with reimbursement models including value based care/ACO modeling + Ability to program using SQL + ... and human resource performance and establish a culture focused on adding business value ? That is what the new generation of human resource transformation is all… more
- Humana (Hartford, CT)
- …and developing teams. + Strong knowledge and experience of Provider engagement, value - based arrangements, Quality/Stars, and Medicare Risk Adjustment. + ... with a focus on Provider Engagement, outcomes/results, Quality/Stars, and Medicare Risk Adjustment. Represents the health plan externally to...posting. The pay range may be higher or lower based on geographic location and individual pay will vary… more
- Humana (Hartford, CT)
- …an organization focused on continuously improving consumer experiences **Preferred Qualifications** + Medicare Advantage knowledge + Value Based relationship ... include oversight and ownership of modeling and assumption setting supporting value based relationships, reporting for expected provider performance, and… more