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  • Defining Best-In-Market Health Opportunities
    health plans=CDHP;Group health plans;Health care costs;Health care quality;Health economics;Health insurance;Health ... insurance;Health maintenance organization=HMO ;Managed care;Preferred provider organization=PPO;Prescription ...

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    • Authors: Dale Yamamoto, Mindy S Kairey
    • Date: Jun 1998
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; External Forces & Industry Knowledge>External forces and business performance; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Innovative solutions
    • Publication Name: Record of the Society of Actuaries
    • Topics: Economics>Health economics; Health & Disability>Health care; Health & Disability>Health care quality; Health & Disability>Health insurance
  • 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 ...

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    • 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
  • Design and Pricing of Tiered Network Health Plans
    Design and Pricing of Tiered Network Health Plans This article discusses the advantages, logistical ... quality and cost-effectiveness standards. Accountable care organizations= ACO;Assumptions;Behavioral econo ...

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    • Authors: Peter Horman
    • Date: May 2009
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Results-Oriented Solutions; Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Process and technique refinement
    • Publication Name: Health Watch
    • Topics: Economics>Health economics; Health & Disability>Health care quality; Modeling & Statistical Methods
  • Long-Term Disability Buyouts
    total removal of the business, with the name of the direct writer no longer on the contract, there's an immediate ... auditors told us. One of the other advantages to the direct writer is freeing up capital. The risk- based capital ...

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    • Authors: Michael Gabon, Stephen Mitchell, Daniel D Skwire
    • Date: Oct 2000
    • Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; Professional Values>Practice expertise; Strategic Insight and Integration>Effective decision-making
    • Publication Name: Record of the Society of Actuaries
    • Topics: Economics>Health economics; Health & Disability>Disability insurance; Modeling & Statistical Methods>Stochastic models; Reinsurance>Reserving - Reinsurance