Actuary – Value-Based Care

This is a fully remote position, open to applicants in Alabama, +44 more states.

📋 Description

• Perform analyses, pricing, and risk assessments to project financial outcomes.

• Assist the Vendor Analytics Team in ensuring that VBC contracts are actuarially robust and deliver financial value.

• Create financial models for value-based care arrangements, including shared savings/risk, capitation, bundled payments, and specialty carve-outs.

• Evaluate claims and vendor performance data to set baselines, measure effectiveness, and detect trends.

• Offer analytical support and expertise during negotiations with external vendors.

• Convey complex findings and recommendations to both technical and non-technical stakeholders, including leadership.

• Work collaboratively with internal teams to gather insights, align strategies, and ensure that VBC strategies are analytically sound, operationally viable, and in harmony with enterprise objectives.

• Identify issues within vendor contracts and performance, develop analytical solutions, and drive resolutions.

• Collaborate with Medicare/Marketplace and Medicaid teams to evaluate the impact of program and policy changes on trends and vendor contracts.

• Investigate and pinpoint new business opportunities.

• Utilize mathematics, probability, statistics, finance, and business principles to determine financial outcomes.

• Carry out other assigned duties and adhere to all policies and standards.

⛳️ Requirements

• Bachelor's Degree in a related field or equivalent experience is required.

• A minimum of 5 years of actuarial experience with an ASA designation, or 4 years with an FSA designation.

• Associate in Society of Actuaries (ASA) certification is mandatory.

• Membership in the American Academy of Actuaries (MAAA) is preferred.

• Experience with vendor arrangements, healthcare claims and revenue data, and trend analysis is necessary.

• Preferred technical skills include proficiency in Excel, SQL, Teradata, and Snowflake.

• Strong understanding of mathematics, probability, statistics, finance principles, and business concepts.

• Fully remote position available within the continental U.S.

• Qualified candidates with arrest or conviction records will be considered in compliance with the LA County Ordinance and the California Fair Chance Act.

🏝️ Benefits

• Competitive salary.

• Health insurance coverage.

• 401K plan.

• Stock purchase plans.

• Tuition reimbursement options.

• Paid time off in addition to holidays.

• Flexible work arrangements, including remote, hybrid, field, or office schedules.

• Additional forms of incentives may be included in total compensation.

• Equal opportunity employer dedicated to diversity.