Actuary 5
We are looking for a strategic and analytical Senior Actuary to lead initiatives in forecasting healthcare cost trends and supporting value-based contracting strategies. This role is pivotal in shaping financial projections, evaluating provider performance, and driving innovative payment models that align incentives with outcomes.
Key Responsibilities
- Develop and maintain robust models to forecast medical and pharmacy cost trends across lines of business.
- Support the design, pricing, and evaluation of value-based contracts with providers, including shared savings, capitation, and bundled payment arrangements.
- Collaborate with clinical, network, and finance teams to align actuarial insights with business strategy.
- Analyze historical utilization and cost data to identify trend drivers and emerging risks.
- Provide actuarial leadership in contract negotiations, performance guarantees, and risk-sharing arrangements.
- Present findings and recommendations to senior leadership and external stakeholders in a clear, actionable manner.
- Mentor junior team members and contribute to the development of actuarial best practices.
Qualifications
- ASA or FSA designation from the Society of Actuaries.
- 8+ years of actuarial experience in healthcare, with a strong focus on cost trend analysis and/or provider contracting.
- Deep understanding of healthcare utilization patterns, risk adjustment, and payment models.
- Proficiency in data analysis tools such as SQL, SAS, R, or Python.
- Strong business acumen and communication skills, with the ability to translate complex analytics into strategic insights.
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