- Lead the review of Medicaid capitation rate assumptions and methodology
- Provide oversight to financial/encounter data submission in support of Medicaid capitation rate setting
- Provide expertise and consultation to support the Medicare bid process and pricing strategy
- Evaluate the financial performance for Medicaid/Medicare lines of business
- Maintain an understanding of the changing health care trends and actuarial regulations and how they impact the organization
- Remain current on government regulation and guidance as well as analytic techniques and methodologies, data sources
- Build and maintain relationships with other leaders across the organization including Product, Finance, Regulatory, Pharmacy, and outside the organization (CMS, provider groups)
- Coach and set priorities for direct reports
- Colorado
- Hawaii
- Massachusetts
- New York
- Ohio
- Pennsylvania
- Bachelor's Degree in Statistics, Computer Science, Mathematics, Social Science or another related field of study
- 5+ years of healthcare actuarial experience; Experience working with Medicare Advantage pricing and bid development
- Experience with writing queries in SQL or another programming language
- Demonstrated experience applying project management skills in data-related and financial analysis projects
- Master's Degree in Statistics, Computer Science, Mathematics, Social Science or another related field of study
- Fellow or Associate in the Society of Actuaries (FSA or ASA)
- Experience certifying the Medicare Advantage Bid
- Experience with Commercial, Medicare, and Medicaid revenue methodologies
- Demonstrated experience with managing professional staff who work independently on tasks and projects
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Manager Actuarial Analytics, Medicare - Portland, United States - Providence Health & Services
Description
Job DescriptionProvidence Health Plan caregivers are not simply valued - they're invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
Providence Health Plan is calling a Manager Actuarial Analytics who will:
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
About Us
At Providence, our strength lies in Our Promise of "Know me, care for me, ease my way." Working at our family of organizations means that regardless of your role, we'll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.
The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.
Check out our benefits page for more information about our Benefits and Rewards.
About the Team
Providence Shared Services is a service line within Providence that provides a variety of functional and system support services for our family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
Providence is proud to be an Equal Opportunity Employer. We are committed to the principle that every workforce member has the right to work in surroundings that are free from all forms of unlawful discrimination and harassment on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law. We believe diversity makes us stronger, so we are dedicated to shaping an inclusive workforce, learning from each other, and creating equal opportunities for advancement.
