- Humana (Pierre, SD)
- …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 (Pierre, SD)
- …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
- Highmark Health (Pierre, SD)
- …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