- CVS Health (Chicago, IL)
- …taking into account evolving marketplace dynamics 3) Communicate results to senior leadership * Collaborate with various departments to understand monthly results ... is responsible for rate development and filings in the Individual/Small Group ACA segment: * Contributing to the achievement of profitability and membership goals… more
- CVS Health (Chicago, IL)
- …performance of our Individual Exchange business. This role will specifically focus on ACA risk adjustment modeling and analytics. The position is a managerial role ... to risk adjustment: 1) ownership of the internal algorithm to calculate member level ACA risk scores, 2) financial estimates of the risk transfer position, and 3)… more
- Molina Healthcare (Naperville, IL)
- …plan management of unit cost budget. Reviews and updates necessary material to keep senior management and health plan management aware of potential unit cost risks & ... modeling of provider contracts (eg Medicaid, Medicare, CFAD, HIX, ACA Primary Care Enhancements, National/Ancillary, capitation, fee-for-service hospital reimbursement,… more