AVP, Managed Care Contracting, Medical Economics

This is a fully remote position, open to applicants in United States.

📋 Description

• Utilize quantitative analysis to assess risk across diverse value-based care contracts, encompassing P4Q, professional fee capitation, two-sided shared savings models, and global capitation frameworks.

• Possess a comprehensive understanding of healthcare terminology and principles, including medical coding, claims data, and overarching medical economic trends across Part A, B, and D segments.

• Demonstrate strong proficiency in leveraging databases and tools to query, interpret, and construct sensitivity models for evaluating risk propensity.

• Capable of analyzing claims data to create IBNR models that predict future paid claims experiences.

• Collaborate cross-functionally with internal stakeholders regarding the legal aspects of managed care negotiations, financial forecasting, budgeting, and operational execution strategies.

• Exhibit effective verbal, written, and presentation skills to diverse audiences, including physicians, executive management, and external stakeholders.

• Participate in payor JOC meetings to promote alignment on performance targets and objectives.

⛳️ Requirements

• Bachelor’s degree (B.A.) in actuarial science, healthcare economics, quantitative analysis, mathematics, or a related field; a background in statistics would be advantageous for this role.

• Experienced healthcare economist or actuary with a background in payor or benefits consulting.

• ASA or FSA designation is required, or progress towards obtaining these designations.

• Experience in client-facing roles is essential.

• Strong analytical skills and proficiency in Microsoft Office, particularly in Word, Excel, and PowerPoint.

• Experience across a variety of health insurance products is highly desirable, including Medicare, Medicaid, commercial, and exchange lines of business.

🏝️ Benefits

• Health, dental, and vision insurance.

• 401(k).

• Paid time off and company holidays.

• Opportunity to influence the future of healthcare technology within a fast-growing value-based care organization.