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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