The Health Foundations e-course explores health care terminology, coding, data sources, claims and more. The modules show examples of how you can combine these elements to help provide solutions to actuarial problems.
Section 1: Overview
Section 2: Medical Terminology and Coding
Section 3: Use of Medical Terminology and Coding
Section 4: Data Warehouse Detail and Data Quality
Section 5: Interrelationship of Administrative Systems
Section 6: Predictive Modeling
After you complete this e-course, you should be able to:
- Define medical terminology and coding and their relevance to health care actuarial work.
- Interpret sources of health care data; decide which source to use and know how to use it.
- Describe claim information in a data warehouse and evaluate it for quality.
- Identify a variety of administrative systems and describe the interrelationships between them.
- Describe the purpose for and applications of predictive analytics in healthcare
- Understand key considerations in model development
- Individuals engaged in the actuarial profession at any level looking to fulfill their CPD requirement.
- Other professionals interested in or impacted by important topics related to the actuarial field.
The following books are referenced in this e-course. You'll be directed to appropriate readings within the context of the e-course. While these materials are not required, they're recommended to enhance the learning experience.
- Duncan, Ian. 2014. Managing and Evaluating Healthcare Intervention Programs. Second Edition. ACTEX.
- Duncan, Ian. 2018. Healthcare Risk Adjustment and Predictive Modeling. Second Edition. ACTEX.
- This e-course is for professional development. It's not intended to substitute for any professionalism requirements for the ASA, CERA or FSA credentials. If you wish to register for an e-learning module to attain a designation, please visit the e-learning module Web page .
- Ultimately, it's an actuary's responsibility to make a reasonable, good-faith determination of what continuing education opportunities will enhance his or her ability to practice in a desired field. For more information on continuing education requirements, visit soa.org/CE .