Actuarial Manager/Senior Manager - Value-Based Care (VBC) Contracting

Location: Fully Remote (U.S.)
Level: Manager/Senior Manager
Practice Area: Medicare Advantage, Medicaid, Provider Contracting, Value-Based Care

A leading health plan is seeking an Actuarial Manager to join a growing team focused on Value-Based Care (VBC) strategy and provider contracting. This position offers the opportunity to partner closely with contracting, network, finance, and executive leadership teams to develop innovative provider reimbursement arrangements that improve clinical outcomes and manage healthcare costs across Medicare and Medicaid populations.

This is an excellent opportunity for a newly credentialed ASA/FSA or actuarial professional who wants to play a highly visible role at the intersection of actuarial analytics and provider strategy.

Key Responsibilities

• Support the development, evaluation, and negotiation of value-based care and provider contracting arrangements.
• Analyze financial performance of provider contracts, risk-sharing agreements, and alternative payment models.
• Partner with provider contracting and network management teams to establish reimbursement strategies and contract terms.
• Develop actuarial projections, financial models, and performance monitoring tools related to VBC initiatives.
• Evaluate the impact of provider incentives, quality programs, and risk-adjustment performance.
• Present findings and recommendations to senior leadership and cross-functional stakeholders.
• Support strategic initiatives across Medicare Advantage and Medicaid lines of business.
• Ad hoc work related to market analytics/intelligence with a focus on products and profitiability.

Qualifications

• ASA or FSA designation required; newly credentialed FSAs are encouraged to apply.
• Approximately 3-8+ years of actuarial experience within health insurance, managed care, consulting, or provider-focused environments.
• Experience supporting provider contracting, value-based care programs, risk-sharing arrangements, or alternative payment models.
• Strong understanding of Medicare Advantage and/or Medicaid products.
• Advanced analytical and financial modeling skills.
• Ability to communicate complex actuarial concepts to non-technical stakeholders.
• Prior leadership, project management, or mentorship experience preferred.

What Makes This Opportunity Attractive?

• Fully remote flexibility.
• High-impact role influencing provider strategy and value-based care initiatives.
• Significant exposure to executive leadership and cross-functional decision-making.
• Opportunity to help shape innovative contracting arrangements in a rapidly evolving healthcare landscape.
• Clear path for continued leadership growth within a growing actuarial organization.
• Extensive exposure to various populations of coverage

If you're an actuarial professional with a passion for provider contracting, value-based care, and healthcare transformation, we'd love to connect. Please apply to the advert and the team will respond shortly.