4 jobs found in denver

Job description We have a great opportunity for an  Analyst, Actuary!  The ideal candidate is responsible for leading the  actuarial analysis  of existing and new commercial integrated kidney care programs. Specifically, this teammate will review and model medical claims and membership data received from external partners. Duties also include applying predictive models, researching health care industry trends, and developing executive-level presentations. Essential Function : Complete program financial and membership reconciliations and monitor developing program experience Analyze drivers of program performance and communicate results to leadership team and internal stakeholders Apply actuarial underwriting principles to value-based contracting efforts, including baseline and trend calculations Create internal performance benchmarks and assist in actuarial process and capability development. Other duties as assigned....

Job description At us, we find that our best leaders are those who create an inspiring vision for the future and empower their team to achieve success. They have always enjoyed tackling difficult problems and believe that the best way to solve them is through collaborative, team efforts. They take ownership of results and instill accountability in those they lead. They are driven, strong communicators, relationship builders, and find real fulfillment in challenging work. Sound like you? Then you might be a great fit for Senior Analyst, Compliance (Clinical Documentation and Billing Investigations) with us.     Here’s what you can expect as a Compliance Senior Analyst at us: This position reports to the Manager, Corp Compliance overseeing Clinical Documentation and Billing Investigations and will apply their experience with investigations, audits, and/or consulting projects to identify and evaluate compliance and regulatory risks associated with...

Job description We are seeking a Compliance Investigator, responsible for conducting investigations on compliance related matters submitted through our compliance hotline or other reporting avenues.  Investigations include potential compliance policy or federal healthcare law-related matters, including Anti-Kickback Statute, False Claims Act, and other laws and regulations related to healthcare compliance. The Compliance Investigator will coordinate with our other departments, including legal and human resources, to handle all aspects of investigations, including gathering relevant documentation, conducting interviews, documenting investigations, and recommending corrective action as necessary.   SUPERVISORY RESPONSIBILITIES: None   ESSENTIAL DUTIES AND RESPONSIBILITIES: Conduct compliance investigations across business areas.  Investigations process may include research, data analysis, process analysis, interviews, follow-up,...

Job description We are seeking a Compliance Investigator, responsible for conducting investigations on compliance related matters submitted through our compliance hotline or other reporting avenues.  Investigations include potential compliance policy or federal healthcare law-related matters, including Anti-Kickback Statute, False Claims Act, and other laws and regulations related to healthcare compliance. The Compliance Investigator will coordinate with our other departments, including legal and human resources, to handle all aspects of investigations, including gathering relevant documentation, conducting interviews, documenting investigations, and recommending corrective action as necessary.   SUPERVISORY RESPONSIBILITIES: None   ESSENTIAL DUTIES AND RESPONSIBILITIES: Conduct compliance investigations across business areas.  Investigations process may include research, data analysis, process analysis, interviews, follow-up,...