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Validating a Novel Health Insurance Fraud Detection Method
Validating a Novel Health Insurance Fraud Detection Method This article describes methodologies ... Health care fraud;Predictive modeling;Medicare;Health insurance;Health economics;Health care costs;Data ...- 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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Risk Management, August 2018
2017 Actuarial Research Conference (ARC) on health care fraud detection. In the March issue of Risk Management ... health insurance fraud detection method. This health care fraud study aims to develop a pro- phetic modeling ...- Authors: Society of Actuaries
- Date: Aug 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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How to Prevent the Big Mistake
financial hiccups in the life industry in both the primary and reinsurance markets. The cyclical nature of ... a similar risk in another product category, to direct resources to the former and away from the latter ...- Authors: Edward Betteto
- Date: Mar 2003
- Competency: External Forces & Industry Knowledge>Actuarial theory in business context; Strategic Insight and Integration>Big picture view; Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Reinsurance News
- Topics: Enterprise Risk Management; Finance & Investments>Asset liability management; Finance & Investments>Portfolio management - Finance & Investments; Finance & Investments>Risk measurement - Finance & Investments; Modeling & Statistical Methods>Sensitivity testing; Modeling & Statistical Methods>Stochastic models
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The New Risk Management Professionals
by the new risk manage- ment professionals. A primary tool used by actuaries for managing risk was conservatism ... They were developed in the context of pricing primary and derivative securities, with variability of ...- Authors: Narayan S Shankar
- Date: Nov 2004
- Competency: Professional Values>Practice expertise; Technical Skills & Analytical Problem Solving>Incorporate risk management
- Publication Name: Small Talk
- Topics: Enterprise Risk Management; Enterprise Risk Management>Capital management - ERM; Enterprise Risk Management>Portfolio management - ERM
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What does ERM mean for Health Practitioners?
Why Care About Enterprise Risk Management? I n late 2008, the health insurance industry faced a number ... Garnett 10 New Member Impact on Medicaid Managed Care Costs By Bela Patel Fernandez and Jeff Smith ...- Authors: Max Rudolph
- Date: Feb 2010
- Competency: External Forces & Industry Knowledge>External forces and business performance; Relationship Management>Staff management and motivation; Results-Oriented Solutions; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Incorporate risk management
- Publication Name: Health Watch
- Topics: Economics>Health economics; Enterprise Risk Management; Modeling & Statistical Methods>Forecasting
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Risk Management, March 2017
Offi- cer, Application of ERM National Long-Term Care Needs and Parameter Uncertainty. Finally, be on ... have a clearer picture of the future of health care. Brexit will eventually get moving along. Teresa ...- Authors: Society of Actuaries
- Date: Mar 2017
- 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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rm-2017-iss-40-harwood
that are familiar to managers and that help them direct effort to achieve the desired result. Can this ... THE FIRM? Behemoth seeks edgy other to join crazy care of customers, never sleeping, continually creative ...- Date: Dec 2017
- 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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Addressing climate change belongs in the insurance companies
mitigation sides. The study has revealed that eight primary factors hinder the expansion of market- based ... of 21 primary insurance and reinsurance companies around the world. These included twelve primary insurers ...- Authors: Maryam Golnaraghi
- Date: Aug 2018
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>External forces and business performance; Leadership>Change management; Leadership>Influence; Leadership>Professional network leverage; Leadership>Thought leadership; Strategic Insight and Integration>Effective decision-making; Strategic Insight and Integration>Influence decisions; Strategic Insight and Integration>Strategy development; 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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International Survey of Emerging Risks
As the survey evolves, informa- tion such as primary practice area also may be included. The survey ... paint, nano-coated clothing, cosmetics or health care), exhibit- ing unexpected, novel properties and ...- Authors: Max Rudolph
- Date: Aug 2008
- Competency: Technical Skills & Analytical Problem Solving>Incorporate risk management
- Publication Name: International News
- Topics: Enterprise Risk Management
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Risk Management, December 2017
the firm. 3. Alignment—consistency between the primary strategic objectives of the firm and the objectives ... manage- ment programs, so that ERM supports the primary goals of the firm. 4. Adaptability—planning to ...- Authors: Society of Actuaries
- Date: Dec 2017
- 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