Remote Director Actuarial Services

Summary

Join Imagine Pediatrics as Director, Actuarial Services and lead an actuarial team to conduct and present analytics on several business-critical initiatives. This position will be instrumental in supporting a value-based care business model for the pediatric Medicaid population.

Requirements

• Associate or Fellow of the Society of Actuaries
• Bachelor’s degree
• Minimum of 8 years of health actuarial experience with significant experience in Medicaid products, experience with value-based reimbursement strategies and affordability initiatives preferred
• Prior leadership experience with demonstrated ability to both lead and execute
• Ability and willingness to train and transfer knowledge to junior level staff
• Actuarial knowledge of best practices for evaluation, modeling (cost, risk score and revenue) and analytics
• Strong SQL skills
• Ability to work effectively in a dynamic and fast-paced environment
• Strong communicator (both written and verbal) with an ability to break down complex and technical concepts in an easy-to-understand way
• Strong organizational, documentation and problem-solving skills
• Strong business acumen and interpersonal skills

Responsibilities

• Lead efforts in establishing value-based care targets (total cost of care, utilization, etc.)
• Develop a process and internal capabilities to measure the performance of value-based / shared savings arrangements and communicate valuable insights to key stakeholders
• Oversee monthly development and application of IBNR estimates
• Apply your knowledge of Medicaid reimbursement components and healthcare claims data to assist with the development and ongoing execution of cost and revenue forecasting models
• Partner with the Healthcare Economics (claims data analytics) team to demonstrate value our clients achieve with Imagine through the reporting of revenue / risk score trends, healthcare utilization trends, and financial savings
• Analyze profitability by duration, acuity, and resource allocation to inform strategic recommendations to senior leadership
• Work closely with other finance teams to monitor performance against forecasts, analyzing and explaining drivers of variances from revenue, cost, and membership
• Prepare analyses for shared savings settlement discussions with payer partners