2 actuary medicaid trend analytics and data management jobs found

Lensa is a career site that helps job seekers find great jobs in the US. We are not a staffing firm or agency. Lensa does not hire directly for these jobs, but promotes jobs on LinkedIn on behalf of its direct clients, recruitment ad agencies, and marketing partners. Lensa partners with DirectEmployers to promote this job for Molina Healthcare. Clicking "Apply Now" or "Read more" on Lensa redirects you to the job board/employer site. Any information collected there is subject to their terms and privacy notice. Job Description JOB SUMMARY: The CDA Analyst supports enterprise risk adjustment and quality initiatives by collecting, validating, and analyzing clinical and claims data. This role develops reporting solutions that improve clinical data capture, support RADV/CDA activities, and assist HEDIS and quality teams with audit readiness, rate tracking, and intervention monitoring. The analyst transforms complex datasets into actionable insights that guide operational decisions...

Position Overview At PNC, our people are our greatest differentiator and competitive advantage in the markets we serve. We are all united in delivering the best experience for our customers. We work together each day to foster an inclusive workplace culture where all of our employees feel respected, valued and have an opportunity to contribute to the company's success. As a Portfolio Analytics and Strategy Analyst Senior within PNC's Monitoring under Enterprise Fraud Organization (EFO) you will be based in Pittsburgh, PA or Cleveland, OH. As part of the Enterprise Fraud Organization (EFO), the React Identify team focuses on quickly identifying emerging fraud trends and uncovering potential gaps in fraud mitigation processes through anomaly detection and data analytics. The key responsibilities of this role include: Developing effective anomaly detection metrics and monitoring tools to identify potential fraud. Analyzing data to detect suspicious activity,...