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Analyst, Actuarial - Nashville, United States - Wellvana Health LLC
Description
The Why Behind Wellvana:
The healthcare system isn't designed for health. We're designed to change that.
We're Wellvana, and we help doctors deliver life-changing healthcare.
Through our high-touch approach to value-based care, we're moving beyond fee-for-service and helping tie the healthy outcomes of patients directly to healthier profitability for primary care physicians, payors, and health systems.
Physicians and health systems in our curated network retain full ownership while Wellvana takes on all the upfront risk, investing capital, people-power and customized medical management strategy to help each provider flourish on their path to full-risk value-based care.
Named a Best Place to Work by Nashville Business Journal and featured in Insider's 33 startups "investors expect to take off in 2023," we're one of the fastest-growing companies in America because what we do works.
Clarity on the Role:
The Analyst, Actuarial, will work closely with Wellvana's actuarial, finance and analytics team in the development of value-based care insights supporting our vision, strategic direction, and performance.
Scope of duties will include but not be limited to medical and pharmacy expense analyses, pre-sales analytics, underwriting, actuarial forecasting, and population health management analyses.
This role consults and collaborates with leadership regarding financial results and forecasting.This position will be key in supporting the business to meet financial objectives by identifying and quantifying opportunities and risks, through key root-cause analyses, and providing recommendations.
The role will need to be able to successfully work within a complex but nimble environment. This position will work closely with and report to the Sr. Director, Actuarial.What's Expected:
Execute on the strategy and manage actuarial accrual and trend analytic activities, medical and pharmacy data collection and perform ad-hoc analyses
Foundational understanding with aptitude to become a subject matter expert in Medicare Advantage, ACO REACH, MSSP and other value-based care programs
Collaborate with other team members to identify, design, and execute analytics to uncover critical business insights that facilitate improved business decisions for senior leadership; analytics may include actuarial, HCE and/or data science related solutions
Present findings in clear, compelling manner to leadership and peers to provide information needed in supporting decision-making
Measure and project savings for new and existing affordability initiatives and recommend new initiatives in collaboration with clinical leadership
Quantify impact of policy reform, population shifts, etc. on existing products and customer arrangements
Project medical expenses for forecasting purposes and monitor variance to budget
Serve as resource to Actuarial leadership
Prepare and provide supporting documentation for actuarial liabilities included in the company's financial statements
Communicate results, findings, and recommendations to the organization
Demonstrate understanding of applicable laws and regulations as well as the actuarial code of conduct and actuarial standards of practice
Program and analyze key reports related to Actuarial initiatives
Requirements
Integrity:
The right way is the only way.
Dependability:
You do what you say you're going to do.
Advocacy:
You fight for the best possible outcome for providers and their patients.
Clarity:
You make it all understandable.
Successfully passed 3+ actuarial exams
Bachelor's degree
3+ years of actuarial experience
3+ years direct experience with healthcare data and analytics
Substantive knowledge of Medicare healthcare industry and trends; medical, pharmacy/Part D, SDoH, behavioral health experience especially valuable
Superior conceptual, analytical, financial modeling, and problem-solving skills
Act as a trusted advisor to key stakeholders throughout the organization
Ability to effectively communicate with various levels of staff
Strong interpersonal and relationship building skills to support collaboration at all levels of the organization
Openly and actively communicate information and take initiative to communicate extensively
Excellent written, verbal, and presentation skills
Preferred Competencies:
ASA or FSA
Medicare Advantage Part C and D bid development expertise
Highly effective written, oral, and persuasive communication skills
Develop, translate and execute strategies or functional objectives for the business
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