- Assist in negotiating risk-based contracts, helping with redlines, and performing ad hoc financial modeling
- Play a key role in creation of reserving/forecasting models, benchmarking and other business models to provide actionable insights to stakeholders
- Collaborate with the accounting and finance teams to help complete risk settlements and provide guidance on revenue projections.
- Partner with the analytics team to apply actuarial standards of practice to healthcare data, identifying and resolving issues as they arise, and enhancing reporting summaries to help manage insurance risk
- Support the Sales teams by implementing tools and process to enhance prospective client engagements - including supporting population analytics
- Support the creation of models to calculate clinical program performance and produce an ROI
- A Depth of knowledge and hands-on experience with contracting, healthcare data analytics, reserving, and financial forecasting
- Proven ability to work cross-functionally and build collaboration and consensus across different stakeholders
- Skilled at presenting complex findings in a simple and understandable way to external and internal audiences of various levels
- Self-sufficient, ready to roll up your sleeves, and not afraid of ambiguity
- Solution-focused with a strong client presence
- A self-starter with ability to work effectively across multiple competing priorities
- 8+ years of relevant actuarial experience in the healthcare industry (e.g. insurance database environments, commercial/employer health insurance pricing, reserving, financial forecasting, provider contracting)
- Strong background working with healthcare data and building effective data summaries using SQL/SAS/etc.
- Comprehensive knowledge and understanding of healthcare financial and operational data and reporting
- Experience with reserving, value-based arrangements, provider operations, and provider contracting preferred
- Experience in commercial/employer lines of business preferred
- Bachelor's Degree in Economics, Statistics, Mathematics, Actuarial Science, Finance, or an equivalent field
- Designation/Credential: ASA or FSA
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Actuary - Not specified, United States - apree health
Description
Actuary, Actuarial Services
About the Company
apree health - is seeking an experienced healthcare Actuary to join our Actuarial Services team.
About the Team
The Actuarial Services team is responsible for value-based contracting, financial forecasting, and ad hoc medical management. Our team uses a diverse array of data to provide analytic insights that support the entire organization, including operations, sales, analytics, and patient-care teams delivering Advanced Primary Care.
We are a collaborative and flexible team that gets excited about actuarial science and the role it plays in strategic decision making. Our culture is one of teamwork, mutual respect, learning, and growth.
We utilize technical tools that include: Excel, SQL/DataGrip/Bigquery, Tableau, Gitlab, Pytho, R, and SAS
About the Job
Our Actuarial Services team is seeking an Actuary, Actuarial Services who will be responsible for supporting contracts involving financial risk from sales through to financial settlement. This includes working with seriatim claims/enrollment/risk adjustment data, financial modeling, contract review, and other ad hoc analyses. The role will help support Sales, Finance, and Operations in identifying and developing strategic growth opportunities, partnering with payers, providers, and service partners to identify risk (insurance, pricing, technical, performance, etc.) and revenue opportunities.
This team member will report directly to the Senior Director of Actuarial Services.
Business Role and Responsibilities:
