Health Foundations 2.0 e-Course

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.

Course Outline

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

Learning Objectives

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

Length

50-60 Hours

Audiences

• 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.

Resource Materials

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.

Notes

• 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 .