Develop tools to measure the performance of value-based arrangements.
Partner with the Healthcare Economics team to report revenue trends.
Analyze profitability to inform strategic recommendations to senior leadership.
Imagine Pediatrics is a tech-enabled, pediatrician-led medical group that reimagines care for children with special health care needs. They deliver 24/7 virtual-first and in-home medical, behavioral, and social care, working alongside families, providers, and health plans.
Maintain internal CMS HCC and RxHCC models for calculating member level risk scores.
Support the monthly close process, including the development of actuarial risk adjusted revenue accruals and analysis of results.
Build reports to track ROI on various risk adjustment initiatives.
Clover Health is reinventing health insurance by combining the power of data with human empathy to keep their members healthier. They are passionate and mission-driven individuals with diverse areas of expertise, working together to solve the most complicated problem in the world: healthcare.
Proactively provides resources, information, advice, and expertise with coworkers and stakeholders.
Completes work assignments by applying up-to-date expertise within the Commercial Pharmacy Benefit.
Supports actuarial documentation by preparing and reviewing the actuarial portion of financial reports.
Jobgether uses an AI-powered matching process to ensure applications are reviewed quickly and fairly. They identify the top-fitting candidates and share this list with the hiring company who manages the final decision.
Serve as an integral part of HSAG Data Science & Advanced Analytics division.
Exhibit the ability to learn about the primary types of healthcare data and methods for approaching data assessments.
Conduct and interpret analyses, develop appropriate statistical models, manipulate complex databases, and track and evaluate patterns of care and outcomes.
Health Services Advisory Group (HSAG) is a nationally recognized leader in healthcare data analysis, measure development, and survey research. They are transforming the delivery of healthcare in the United States with a growing team and offer opportunities to give back to the community.
Analyze data to assist in the design of Value Based Programs.
Develop analytic and/or report requirements that support informed decisions regarding strategy initiatives.
Help identify, research, and resolve operational and other business issues relating to value-based programs and initiatives.
Capital Blue Cross is committed to the health and well-being of its members and communities. They have been voted as one of the “Best Places to Work in PA” and foster a flexible environment where employees are encouraged to volunteer and grow professionally.
Using Generative AI tools and your technical acumen to build tools to automate existing processes and develop new tools to drive efficiency gains and improve analytical insights
Performing actuarial pricing analyses, including statewide and segmented indications for homeowners insurance products
Developing and enhancing pricing methodologies, incorporating loss trends, expense assumptions, reinsurance costs, catastrophe modeling outputs
Kin is redesigning insurance to be smarter, faster, and centered on the customer. They empower people to protect what matters most, starting with their homes and expanding to all they value. Kin has fostered amazing growth, attracted marquee investors, and earned accolades.
Own and maintain the company’s rating manual, including documentation, assumptions, updates, and ongoing enhancements.
Perform pricing analysis for new and renewing business, ensuring consistency with actuarial standards and internal guidelines.
Identify opportunities to improve rating accuracy, efficiency, and automation.
Jobgether uses an AI-powered matching process to ensure applications are reviewed quickly, objectively, and fairly against the role's core requirements. They identify the top-fitting candidates, and this shortlist is then shared directly with the hiring company.
Assist in the processing and calculation of the practice portion estimates.
Prepare month-end reporting workbooks related to practice portion expense, including related journal entries and reconciliations.
Understand contract terms to ensure the distribution of monthly and/or quarterly payments to practice are in line with the contracts; serve as a liaison between Aledade Finance/Accounting and Aledade practices/markets to communicate payment distribution.
Aledade is empowering independent primary care practices. They were founded in 2014 and have grown to be the largest network of independent primary care in the US with a remote-first culture.
Perform comprehensive analysis of healthcare claims data using advanced statistical and analytical methods; prepare reports summarizing key findings.
Collaborate with management, investigators, and analysts to support proactive and reactive case development efforts by fulfilling data requests.
Apply techniques such as data mining, statistical modeling, and predictive analytics to identify anomalies in Medicare/Medicaid claims.
CoventBridge Group is a global full-service investigation firm providing data analytics and investigative solutions to government and commercial clients. They have 1000 employees and affiliates worldwide and are committed to top tier data privacy and security practices.