Actuary – Value-Based Care

Overview

This role involves conducting analysis, pricing, and risk assessment to estimate financial outcomes. You will support the Vendor Analytics team in ensuring value-based care (VBC) contracts are actuarially sound and provide financial value.

Responsibilities

• Lead development of financial models to assess financial risk and opportunity associated with proposed and existing value-based care (VBC) arrangements, including shared savings/risk, capitation, bundled payments, and specialty carve-outs
• Analyze claims and vendor performance data to establish baselines, measure performance, and identify trends
• Provide analytical support and subject matter expertise during negotiations with external vendors, including financial terms, risk structures, and analytical methodologies
• Communicate complex findings and recommendations to technical and non-technical audiences, including leadership
• Collaborate with internal teams to gather input, align on strategy, and ensure VBC strategies are analytically sound, operationally feasible, and aligned with enterprise goals
• Independently identify issues in vendor contracts and performance, develop analytical approaches, and drive solutions
• Work with Medicare/Marketplace and Medicaid teams to assess the impact of program and policy changes on trends and vendor contracts
• Research and identify new business opportunities
• Apply knowledge of mathematics, probability, statistics, principles of finance, and business to calculate financial outcomes
• Perform other duties as assigned and comply with all policies and standards

Requirements

• Bachelor’s Degree in related field or equivalent experience required
• 5+ years of actuarial experience and Associate in Society of Actuaries (ASA) certification required
  • OR 4+ years of actuarial experience and Fellow in Society of Actuaries (FSA) certification required

Preferred Qualifications

• Member of the American Academy of Actuaries (MAAA) preferred
• Experience with vendor arrangements, healthcare claims and revenue data, and trend analysis
• Strategic thinking skills
• Technical skills: Excel, SQL, Teradata, and Snowflake

Compensation & Benefits

• Pay Range: $107,700.00 - $199,300.00 per year
• Benefits may include:
  • Health insurance
  • 401K and stock purchase plans
  • Tuition reimbursement
  • Paid time off plus holidays
  • Flexible approach to work with remote, hybrid, field, or office schedules
• Actual pay will be adjusted based on an individual’s skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status
• Total compensation may also include additional forms of incentives
• Benefits may be subject to program eligibility

Location

• Fully remote within the continental U.S.