- Humana (Jackson, MS)
- …of a team that is at the center of a changing regulatory landscape. The Actuary , Risk and Compliance role assesses and communicates information regarding ... caring community and help us put health first** This Actuary role is a role within the Senior Products...and execution of review standards and controls to minimize compliance risk associated with the bid filing… more
- Highmark Health (Jackson, MS)
- …challenges, ensuring accurate and timely data flow across systems. + **Oversee risk adjustment processes and ensure compliance with regulations:** Stay abreast ... the incumbent to: + **Lead and manage a team of interoperability and risk adjustment SMEs:** Provide guidance, mentorship, and support to team members, fostering a… more
- Molina Healthcare (Jackson, MS)
- …**Job Summary** The Program Manager, Provider Engagement is part of our innovative Risk Adjustment department to assist our diverse team of data leaders, risk ... activities in all government lines of business impacted by the regulatory risk adjustment payment model. They will be accountable for implementing and managing… more
- Highmark Health (Jackson, MS)
- …to pay-for-value programs, episode payments, prospective bundled payments, gain share and risk share models and will be implemented for the Organization's Medicare ... of maximizing quality while reducing healthcare costs. + Work with reimbursement, actuary , and analytic departments to ensure that operational capabilities are built… more