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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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Assessing Prescription Opioid Risk with Predictive Analytics
Assessing Prescription Opioid Risk with Predictive Analytics We highlight a new approach leveraging ... users for more effective screening and follow-up care. Predictive modeling;Health risks;Data mining=Big ...- Authors: Joseph Boschert, Andrew Gaffner, Barbara Collier
- Date: Oct 2018
- Competency: External Forces & Industry Knowledge>Actuarial methods in business operations; External Forces & Industry Knowledge>Actuarial theory in business context; Leadership>Thought leadership; Professional Values>Practice expertise; Strategic Insight and Integration>Effective decision-making; Strategic Insight and Integration>Influence decisions; 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: Health Watch
- Topics: Demography>Population data; Experience Studies & Data; Health & Disability>Health information technology; Modeling & Statistical Methods>Data mining; Predictive Analytics; Technology & Applications>Analytics and informatics; Health & Disability>Electronic medical record
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Predictive Analytics: An Alternative Perspective
been the pricing de- velopment for the Affordable Care Act (ACA). With the change in the underwriting ... QUALITATIVE FACTORS. This high level analy- sis can help direct the research and ensure that a complex analysis ...- Authors: Kurt Wrobel
- Date: Dec 2015
- Competency: Strategic Insight and Integration>Effective decision-making
- Publication Name: Predictive Analytics and Futurism Newsletter
- Topics: Predictive Analytics
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2005 Delphi Study - Reflections 10 Years Later
plausible scenarios. From my perspective, the primary goal of the study was to edu- cate SOA members ... ance/research-ind-mort-risk.aspx • Long Term Care: http://www.soa.org/Research/Research- Project ...- Authors: Steven Easson
- Date: Dec 2015
- Competency: Strategic Insight and Integration>Effective decision-making
- Publication Name: Predictive Analytics and Futurism Newsletter
- Topics: Predictive Analytics
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Society of Actuaries Trend Topic: How Predictive Analytics Can Bolster Organizational Expertise
Society of Actuaries Trend Topic: How Predictive Analytics Can Bolster Organizational Expertise ... simple question had no simple answer. There was no direct way to tell if the money invested in the enterprise ...- Authors: Stephen Fredlund
- Date: Dec 2017
- Competency: Strategic Insight and Integration>Effective decision-making
- Publication Name: Predictive Analytics and Futurism Newsletter
- Topics: Predictive Analytics
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Three Pitfalls to Avoid in Predictive Modeling
Three Pitfalls to Avoid in Predictive Modeling The well-known examples of predictive modeling “successes” ... is to recognize that in three out of the four primary translations (i.e., shift down, shift left and ...- Authors: Marc Alexandre Vincelli
- Date: Jul 2016
- Competency: Strategic Insight and Integration>Effective decision-making; Technical Skills & Analytical Problem Solving>Incorporate risk management; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Predictive Analytics and Futurism Newsletter
- Topics: Predictive Analytics
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Insights from a Dead Salmon
Insights from a Dead Salmon Actuaries provide special subject matter expertise to question (or ... good way. Yes, you put in a lot of time without direct compensation; but the result is highly rewarding ...- Authors: David Snell, Kevin Jones
- Date: Dec 2016
- Competency: Professional Values>Ethical standards; Strategic Insight and Integration>Effective decision-making
- Publication Name: Predictive Analytics and Futurism Newsletter
- Topics: Actuarial Profession; Predictive Analytics
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Company Profitability and Risk Dashboards--A Tool in the Understanding and Management of Risk, Part 1
Company Profitability and Risk Dashboards--A Tool in the Understanding and Management of Risk, ... first step, companies will need to identify the primary risks inherent in their current product portfolios ...- Authors: Marianne C Purushotham, Mark Birdsall
- Date: Sep 2016
- Competency: Communication>Difficult message delivery; External Forces & Industry Knowledge>Internal forces and business performance; Results-Oriented Solutions>Actionable recommendations; Strategic Insight and Integration>Big picture view; Strategic Insight and Integration>Effective decision-making; Strategic Insight and Integration>Influence decisions; Technical Skills & Analytical Problem Solving>Problem analysis and definition
- Publication Name: Small Talk
- Topics: Actuarial Profession>Best practices; Experience Studies & Data>Mortality; Life Insurance>Marketing and distribution - Life Insurance; Predictive Analytics