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Validating a Novel Health Insurance Fraud Detection Method
Validating a Novel Health Insurance Fraud Detection Method This article describes methodologies for detection and deterrence of Medicare fraud. It also describes the validation of PRIDIT for ...- Authors: Robert D Lieberthal, Elias
- Date: Aug 2018
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Risk Management
- Topics: Economics>Health economics; Enterprise Risk Management; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health information technology; Health & Disability>Health insurance; Health & Disability>Public financing - Health & Disability; Modeling & Statistical Methods>Data mining; Predictive Analytics
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A Review of Root Cause in Insurer Insolvencies and Impairments
A Review of Root Cause in Insurer Insolvencies and Impairments The article is based on a study of causes of insolvency and decisions made by management, regulators, and policyholders over the ...- Authors: David Heppen, Veronika Cooper
- Date: Aug 2018
- Competency: External Forces & Industry Knowledge>External forces and business performance; External Forces & Industry Knowledge>Internal forces and business performance; Professional Values>Practice expertise; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Risk Management
- Topics: Enterprise Risk Management>Operational risks; Enterprise Risk Management>Risk measurement - ERM; Finance & Investments>Investments
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Recent Publications in Risk Management
Recent Publications in Risk Management Other articles that will be of interest to readers. Enterprise Risk Management = ERM;Own Risk Solvency Assessment = ORSA 6442485742 12/1/2018 12:00:00 AM ...- Authors: Society of Actuaries
- Date: Dec 2018
- Competency: Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Risk Management
- Topics: Enterprise Risk Management
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Recent Publications in Risk Management
Recent Publications in Risk Management Other articles that will be of interest to readers. Own Risk Solvency Assessment = ORSA;Enterprise Risk Management = ERM 6442482133 3/1/2018 12:00:00 AM ...- Authors: Society of Actuaries
- Date: Mar 2018
- Competency: Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Risk Management
- Topics: Enterprise Risk Management
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Fatness of Tails
Fatness of Tails We can do a better job of communicating the degree of "riskiness" that is inherent in our models of risk. The "Coefficient of Risk" is one way ...- Authors: David Ingram
- Date: Aug 2015
- Competency: Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Risk Management
- Topics: Enterprise Risk Management>Risk measurement - ERM
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Actuarial Guideline 51 Impacts to Regulatory View of Current Predominating LTC Risks
Actuarial Guideline 51 Impacts to Regulatory View of Current Predominating LTC Risks State regulators' review of predominant LTC Risks after review of year-end AG51 reports. long-term ...- Authors: Rhonda Ahrens, Frederick James Andersen
- Date: Dec 2018
- Competency: Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Long-Term Care News
- Topics: Actuarial Profession>Best practices; Enterprise Risk Management>Financial management; Enterprise Risk Management>Risk categories; Enterprise Risk Management>Risk measurement - ERM; Experience Studies & Data>Long-term care - Experience Studies & Data; Experience Studies & Data>Morbidity; Experience Studies & Data>Mortality; Long-term Care>Long-term care insurance
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Risk Management, August 2016 Issue 36 French
Risk Management, August 2016 Issue 36 French Read the August 2016 issue of Risk Management published by the Joint Risk Management Section. Newsletters provide practical information for the ...- Authors: Society of Actuaries
- Date: Aug 2016
- Competency: Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Problem analysis and definition; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Risk Management
- Topics: Enterprise Risk Management
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Risk-Based Capital Update
Risk-Based Capital Update Presented at May 2002 Spring Meeting. This session covers NAIC 2001 changes to RBC requirements, the impact they have had on regulators, the rating agency reaction ...- Authors: Larry M Gorski, Alastair G Longley-Cook, James Reiskytl
- Date: May 2002
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: Record of the Society of Actuaries
- Topics: Enterprise Risk Management>Capital management - ERM; Public Policy
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Health Organization Risk-Based Capital
Health Organization Risk-Based Capital Presented at September 1995 Valuation Actuary Symposium. Discusses the Health Organization Risk-Based Capital formula. Health maintenance organization= ...- Authors: Peter Lynn Perkins, Michael Thompson, William J Thompson, Robert E Wilcox, Donna C Novak
- Date: Sep 1995
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Topics: Enterprise Risk Management>Capital management - ERM; Health & Disability>Health insurance
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DevOps: A Journey to an Efficient Regulatory Compliance Practice
DevOps: A Journey to an Efficient Regulatory Compliance Practice Importance of bringing the DevOps mechanism in order to reduce the operational risks and to create a stable audit compliance ...- Authors: Soumava Dey
- Date: Oct 2018
- Competency: Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Innovative solutions; Technical Skills & Analytical Problem Solving>Process and technique refinement
- Publication Name: CompAct
- Topics: Enterprise Risk Management>Operational risks; Technology & Applications>Computer science