
Cedar Gate Technologies
Remote Jobs
Empowering Payers, Providers, and Employers/ASOs to Excel at Value-Based Care
3 Jobs
Senior Client Services Representative – Healthcare Ops
Cedar Gate TechnologiesEmpowering Payers, Providers, and Employers/ASOs to Excel at Value-Based Care
• Serve as a business leader and process expert within the Value-Based Care Operations team • Ensure successful design, documentation, and configuration of new bundles and their associated claims workflows • Translate process updates and refine strategies for a smooth transition to claims administration • Create use cases for all testing phases related to new value-based clients • Execute regression testing and user acceptance testing, working with claims staff • Lead new initiatives for operating new value-based arrangements by collaborating with Product and Development teams throughout the software development life cycle • Enhance and create claims-related tools to empower operational staff for efficient and effective usage in daily tasks
Senior Client Services Representative
Cedar Gate TechnologiesEmpowering Payers, Providers, and Employers/ASOs to Excel at Value-Based Care
• Triage and respond to incoming client support requests • Coordinate with Product and Data Management teams on issues that require resolution and communicate updates to client • Support the Account Management team by tracking, escalating, and resolving both general and client-specific issues • Develop action plans around incoming client inquiries, responding to client requests, and escalating issues • Own, track, report, and manage support SLAs and ensure delivery against requirements and company goals
Director, Actuarial
Cedar Gate TechnologiesEmpowering Payers, Providers, and Employers/ASOs to Excel at Value-Based Care
• Develop mathematical analyses and financial principles to solve insurance problems that comply with actuarial standards of practice (ASOPs) • Construct value-based contract forecasts of future premiums, claims and risk scores based on past operations and anticipated future changes • Clearly explain value-based contract forecast assumptions, volatility, sensitivity analysis and risks to clients • Streamline repetitive actuarial tasks by leveraging opportunities to integrate methods as software features, enhancing efficiency and productivity. • Assist software developers in deploying software features through the development of written requirements, definition of use cases, user acceptance testing, and serving as a subject matter expert to assure appropriate use of methods as well as proper communication of limitations and disclosures • Collect and compile statistical data for additional analysis • Estimate the probability and likely cost of events such as an accident, death, natural disaster, or sickness • Explain reports, forecasts, and findings to various parties, from company executives to clients, shareholders, and government officials, that comply with actuarial standards of practice (ASOPs) • Build predictive models to accurately analyze potential outcomes • Compare actual ROIs with forecasts • Monitor market trends and identify opportunities for new investments and funds