- Apply quantitative analysis to underwrite risk across various value-based care contracts, including P4Q, professional fee capitation, and global capitation arrangements.
- Utilize healthcare terminology, including medical coding, claims data, and medical economic trends across Part A, B, and D segments.
- Query databases to interpret and build sensitivity models for evaluating risk propensity.
- Develop IBNR models using claims data to predict future paid claims experience.
- Collaborate with internal stakeholders on legal implications, financial forecasting, and operational delivery tactics.
- Engage with physicians, executive management, and external stakeholders through effective verbal and written communication.
- Participate in payor joint operating committee (JOC) meetings to facilitate alignment on performance targets.
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