Manage and develop the processes and internal capabilities necessary to measure performance of value-based / shared savings arrangements and communicate valuable insights to key stakeholders.
Manage monthly development and application of IBNR estimates.
Partner with the Healthcare Economics (claims data analytics) team to demonstrate value our clients achieve with Imagine through the reporting of revenue / risk score trends, healthcare utilization trends, and financial savings.
Analyze profitability by duration, acuity, and resource allocation to inform strategic recommendations to senior leadership.
Work closely with other finance teams to monitor performance against forecasts, analyzing and explaining drivers of variances from revenue, cost, and membership.
Prepare analyses for shared savings settlement discussions with payer partners.

Requirements

Associate or Fellow of the Society of Actuaries
Bachelor’s degree
Minimum of 5 years of health actuarial experience, experience with value-based reimbursement strategies and affordability initiatives preferred
Minimum of 2 years of Medicaid managed care experience
Experience negotiating Medicaid managed care capitation rates is strongly preferred
Prior leadership experience is preferred but not required
Ability and willingness to train and transfer knowledge to junior level staff
Actuarial knowledge of best practices for evaluation, modeling (cost, risk score and revenue) and analytics
Strong SQL skills
Ability to work effectively in a dynamic and fast-paced environment
Strong communicator (both written and verbal) with an ability to break down complex and technical concepts in an easy-to-understand way
Strong organizational, documentation and problem-solving skills
Strong business acumen and interpersonal skills

Benefits

Competitive medical, dental, and vision insurance
Healthcare and Dependent Care FSA; Company-funded HSA
401(k) with 4% match, vested 100% from day one
Employer-paid short and long-term disability
Life insurance at 1x annual salary
20 days PTO + 10 Company Holidays & 2 Floating Holidays
Paid new parent leave
Additional benefits to be detailed in offer

Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools

health actuarial experiencevalue-based reimbursement strategiesMedicaid managed care experiencenegotiating Medicaid managed care capitation ratesactuarial modelingcost modelingrisk score modelingrevenue modelingSQL

Soft Skills

leadership experiencetraining and knowledge transferstrong communicatororganizational skillsdocumentation skillsproblem-solving skillsbusiness acumeninterpersonal skills

Certifications

Associate of the Society of ActuariesFellow of the Society of ActuariesBachelor’s degree