Senior Consulting Actuary: ACA Risk Adjustment
Blue Cross & Blue Shield of NC
Blue Cross NC is seeking a Consulting Actuary specializing in ACA Risk Adjustment. You will lead actuarial pricing strategies, assess care management models, and design innovative insurance products. The role requires strong leadership, cross-functional collaboration, and rigorous financial stewardship. You will engage with regulators and internal teams, ensuring compliance and advanced risk analysis while maintaining ongoing professional development in actuarial practices. #J-18808-Ljbffr Blue Cross and Blue Shield of North Carolina
$143.62k - $229.79k
...Job Description As a Consulting Actuary -ACA Risk Adjustment, you will play a pivotal role in delivering a wide array of actuarial and analytical services... ...transfer forecasting and explanation of results to senior leadership - Highly Preferred Strong understanding of diagnosis...RiskLocal area- ...future.KPMG is currently seeking an Actuarial Health Senior Associate to join our Audit practice.... ...group and health insurance reserves, risk adjustment factors, and actuarial values for a given... ...or modeling Medicaid, Medicare, ACA, group health, long term care, and/or...SeniorRiskWork experience placementH1bLocal area
- ...Senior Actuary Houston, Texas, United States Or refer someone Job Openings Senior Actuary... ...Actuaries) ~ CERA (Chartered Enterprise Risk Analyst) ~ MAAA (Member of the American... ...Associate of the Society of Actuaries) ~ ACAS (Associate of the Casualty Actuarial...SeniorRisk
- Astrana Health Management in Houston is seeking a Risk Adjustment Coding Specialist II to drive risk adjustment efforts through chart reviews, provider education, and KPI reporting. You’ll translate findings into actionable insights and support education for providers and...SeniorRisk
$180.2k - $355.1k
...Capital practice is adding an Actuarial Senior Manager to our Insights,... ...delivering strategic and technical consulting services to help clients... ...modeling, underwriting, and risk analysis methodologies to... ...years of experience with risk adjustment mechanisms, group insurance...SeniorRiskLocal areaVisa sponsorship- Community Health Choice is a nonprofit managed care organization serving Texas. The Risk Adjustment Coder II will review complex medical records, code chronic conditions, and map to HCCs under CMS guidelines. The role supports Commercial and Medicare risk adjustment programs...SeniorRisk
- Community Health Choice, Inc. seeks a Risk Adjustment Coder II in Houston, Texas. The role involves advanced medical record reviews and coding of chronic conditions to ensure correct risk scoring, complying with CMS guidelines and internal policies. The ideal candidate...SeniorRisk
- ...Risk Adjustment Coding Specialist We are currently seeking a highly motivated Risk Adjustment Coding Specialist to support our Houston market. In this role, you will support risk adjustment efforts by conducting high-volume chart reviews to identify coding gaps, trends...Risk
- ...improvement initiatives; track milestones and flag risks to the appropriate project lead. Assist... ...requirements, including ERISA, HIPAA, ACA, COBRA, FMLA, and FLSA. Support... ...improvements, system enhancements, and project adjustments; escalates decisions with broader...SeniorRiskWork at officeShift work3 days per week
- Astrana Health in Houston, TX is seeking a Risk Adjustment Coding Specialist II to join the Quality - Risk Adjustment team. The role conducts provider medical record audits, analyzes coding patterns, and educates providers to ensure accurate CMS payment and quality care...Risk
$70k - $85k
Risk Adjustment Coding Specialist II - Houston Department: Quality - Risk Adjustment Employment Type: Full Time Location: 19500 HWY 249, Suite 570 Houston, TX 77070 Reporting To: Liz Francisco Compensation: $70,000 - $85,000 / year Description We are currently seeking...RiskFull timeWork at office- Astrana Health, Inc. is seeking a Risk Adjustment Coding Specialist II to support Houston market. Travel to provider offices is required twice weekly, with responsibilities including chart reviews, HCC coding, and education delivery to providers. Candidate will review documentation...Risk
$77k - $202k
...AssociateJob Description & SummaryThe OpportunityAs a Health Actuary Consultant - Senior Associate, you will be part of our dynamic team within our... .../Statistics, Organizational Management/Behavior, Risk Management/Insurance, Science, Taxation, Other- Demonstrating...SeniorRiskFull timeH1b$77k - $202k
...Health Actuary Consultant - Senior AssociateAs a Health Actuary Consultant - Senior Associate, you will be part of our dynamic team within our Workforce... .../Statistics, Organizational Management/Behavior, Risk Management/Insurance, Science, Taxation, OtherDemonstrating...SeniorRisk- ...Responsibilities Act as the risk management subject matter expert on assigned project, program, or portfolio, being accountable for... ...in strategic decision‑making. Advise project leadership on risk‑adjusted contingency and schedule reserve ranges based on quantitative economic...SeniorRiskContract workLocal area
- ...****@*****.***: Senior Financial Analyst, Americas Strategic... ..., and communicate findings, trends, risks, opportunities, and recommendations to stakeholders... ...candidates require any reasonable adjustments and/or accommodations when applying to...SeniorRiskPart timeWork at officeLocal areaWorldwide
- ...Senior Financial AnalystAs a Senior Financial Analyst, you will serve as a strategic partner... ..., and financial modeling, to surface risks, opportunities, and recommendationsManage... ...suiteConfidently field questions from executives and adjust messaging to the audience in the...SeniorRiskWork at officeRelocation
- This OpportunityWSP is seeking a Senior Risk Manager to join our Project Controls group in Houston, TX.Your ImpactAct as the risk management... ...strategic decision making.Advise project leadership on risk adjusted contingency and schedule reserve ranges based on quantitative...SeniorRiskContract workLocal areaFlexible hours
$87.7k - $100.1k
...Senior Associate, Risk ManagerAre you ready to lead from the front line of a top 10 bank? Do you thrive... ....Responsibilities:Strategic Risk Consulting: Serve as a trusted advisor to core business... ....Framework Alignment: Map and adjust localized business processes to seamlessly...SeniorRiskFull timePart timeLocal area- ...traded manufacturing company looking to add a Senior Accountant. This will be a very hands on... .../ad-hoc journal entries, balance sheet adjustments, allocations, and reversals Consolidate... ...SOX controls Reconcile and monitor high risk liability, intercompany and accrual accounts...SeniorRisk
- The Sr. Security Risk Analyst provides assessments, gap analysis, and recommendations around... ...practices. Serve as an internal security consultant to teams looking to make IT investments;... ...Job requires the ability to use vision, adjust focus and work on a standard computer...SeniorRiskWork at officeWorldwide
$72.5k - $90k
Governance, Risk, and Compliance Associate or Senior Associate - Asset Management Consulting Job Category : Advisory Requisition Number : GOVER003092 Full-Time Hybrid... ...of 1940 Monitor regulatory updates and help adjust internal procedures as needed Prepare and maintain...SeniorRiskFull timeWork at officeFlexible hoursShift work- ...Senior Financial Planning & Analysis Analyst Job Category: Finance & Accounting Requisition... ...vision, color vision and ability to adjust focus. Working Conditions: The work environment... ...; toxic or caustic chemicals and risk of electrical shock when in the operations...SeniorRiskFull timeWork at office
- Position SummaryThe Senior Director, Compensation, Benefits... ..., promotions, market adjustments, and incentive programs... ...401(k).Manage brokers, consultants, insurance carriers,... ....Compliance and Risk Management - 10%Ensure compliance with ACA, ERISA, COBRA, HIPAA, IRS...SeniorRisk
- Job Overview:The Senior Project Manager is responsible for foreseeing project opportunities and issues and adjusting strategies to embrace or mitigate them. They directly influence and... ...work planning, schedule, cost controls, risk management, progress measurement, and...SeniorRiskContract workFor subcontractor
$148.2k - $292.3k
...healthcare ecosystem. As an Actuarial Manager, you will... ...and technical consulting services to help clients... ...modeling, underwriting, and risk analysis methodologies... ...recommendations for senior client stakeholders and... ...experience with risk adjustment mechanisms, group insurance...RiskLocal areaVisa sponsorship$128k - $173k
...Responsibilities JOB PURPOSEThe Senior Manager, Investment and Risk Management plays a pivotal role in... ...AccountabilitiesInvestment & Risk EvaluationAssess risk‑adjusted returns, key assumptions, and... ..., private equity, corporate M&A, consulting, power or renewable project...SeniorRiskFull timeTemporary workWork experience placement- ...team environment.SUMMARYThe Senior Director of Organizational Effectiveness... ...to inform ongoing design adjustments and demonstrate ROI of... ...functional challenges Strategic Consulting & Problem SolvingAbility to... ...consultative problem-solving, risk management, and project...SeniorRiskFull timeLocal areaShift work
- ...and future! Job Summary: The Senior Manager, Engineering & Construction... ...partners to optimize contract terms, mitigate risks, and drive successful project execution.... ...Disability. Level, Title and/or Salary may be adjusted based on the applicant's experience or...SeniorRiskContract workFor contractorsWork at office
$101.61k - $135.64k
...pillars of our continued success.OverviewThe Senior Project Controls Specialist is... ...continual improvement and opportunities for risk mitigation is a key responsibility of this... ...Quiet environment.Light work that includes adjusting and/or moving objects up to 20 pounds.Pay...SeniorRiskContract workFor subcontractorWork at office
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