- CareFirst (Baltimore, MD)
- **Resp & Qualifications** **PURPOSE:** The Senior Medicare Encounters Risk Adjustment Analyst assumes a pro-active approach in ensuring the accuracy and ... the impact of any changes to the HCC model and supporting actuarial in the calculation risk adjustment revenue. + Assists in designing an overall suite… more
- Excellus BlueCross BlueShield (Rochester, NY)
- …internal and external to ensure accuracy. Supervises reporting, valuation, and forecasting of risk adjustment score and revenues to support partners internal and ... adjudication and reporting. + Provides input into product development process. + Projects risk adjustment factors, model impacts of potential payment changes. +… more
- Amazon (San Francisco, CA)
- …economics reporting and ad-hoc analysis relating to cost of care management - Medicare Risk score projections and premium estimation -Design and implement ... -Value based care contracting support and ongoing financial and risk analysis. -Support ongoing actuarial support for...(ASA) is required -Experience with Medicare or Medicare Advantage products -Strong knowledge of actuarial … more
- Excellus BlueCross BlueShield (Rochester, NY)
- …and external to ensure accuracy. Leads preparation reporting, valuation, and forecasting of risk adjustment scores and revenue to support partners internal and ... you to apply! Job Description: Summary: The Manager of Actuarial Services is responsible for managing a team that...+ Leads preparation of accruals/liabilities for CMS Part D risk sharing and Part C revenue settlements. + Leads… more
- Fallon Health (Worcester, MA)
- …of actuarial components of financial reports, regulatory submissions, and risk adjustment analyses + Collaborate with cross-functional teams including ... **Primary Job Responsibilities** + Assist in the development and maintenance of actuarial models for valuation, forecasting, pricing, and/or risk analysis +… more
- ChenMed (Miami, FL)
- …+ Runs CMS risk adjustment model to calculate member level risk scores. + Provides actuarial support to markets; creates and distributes reports; ... to join our team. Responsible for proactively managing and retrospectively tracking the risk positions within ChenMed as well as supporting the strategic goals of… more
- Point32Health (Canton, MA)
- …will oversee all provider engagement and reporting activities for risk adjustment programs and initiatives that impact Medicare , Medicaid, and Duals product ... Point32Health (https://www.point32health.org/) . **Job Summary** This position will lead the Risk Adjustment Operations & Provider Consulting team responsible… more
- Humana (Richmond, VA)
- …health first** The Risk Management Lead acts as a consultant to the Risk Adjustment team leaders, as programs and initiatives are executed upon. Leveraging ... The Lead will focus on Project Management and is responsible for oversight of the Risk Adjustment Operations processes. The Risk Management Lead works on… more
- Molina Healthcare (Roswell, NM)
- …and development ad-hoc as well as automated analytical modules related to Risk Adjustment for Medicaid, Marketplace and Medicare /MMP. + Assist Risk ... **Job Description** **Job Summary** The Lead, Risk Adjustment - Predictive Analytics role...least one line of business among Medicaid, Marketplace and Medicare /MMP. + 5+ Years of experience in Prospective/Retrospective/Audit targeting… more
- Blue Cross and Blue Shield of Minnesota (Eagan, MN)
- …vendor performance relative to established contracts. * Collaborate with actuarial , finance, Medicare and risk adjustment to ensure all inputs and ... Medicare Provider Relations team! You will apply broad actuarial principles and modeling technical skills to develop solutions...with actuarial , finance, data & analytics, stars, risk adjustment , and other lever owners to… more
- Point32Health (Canton, MA)
- …in a matrix environment collaborating with functions including risk adjustment , population health, finance, operations, actuarial , and sales. **Job ... and products. The Director will lead a team who negotiates contracts including risk arrangements to enable high performing provider networks that support goals for… more
- Point32Health (Canton, MA)
- …key performance indicators for key initiatives + Serve as the key liaison for Actuarial , Finance, Risk Adjustment , Corporate Data and Analytics, Medical Cost ... functional teams (operations, clinical services, network management, finance, and actuarial , etc.) to ensure appropriate product management and successful… more
Related Job Searches:
Actuarial,
Adjustment,
Medicare,
Medicare Risk Adjustment,
Risk,
Risk Adjustment