Note: The job is a remote job and is open to candidates in USA. ConcertoCare is seeking a Senior Actuarial Analyst to shape the company's growth by building actuarial models that guide decision-making across pricing and forecasting. The role involves collaborating with various teams to drive impact and improve performance measurement through data analysis and reporting.
Responsibilities
- Design and perform actuarial studies and reports related to medical costs, risk scores, revenue, and membership, develop strong visuals and key insights to support deliverables to executive leadership
- Analyze results to identify early signs of adverse trends or other issues related to medical care costs and premium based revenue
- Work in collaboration with IT to optimize data ingestion and reconciliation to ensure data accuracy
- Inform the financial forecast with actuarially-sound studies to enhance accuracy
- Analytic support to explain variation from forecasted outcomes and collaborate with adjacent teams to recommend changes to optimize results
- Contributing strong recommendations on how to best measure program impacts with use of historic and predictive analytics
- Support Finance in business development discussions, contributing strong recommendations on how to best structure risk-sharing arrangements through a combination of historic and predictive analytics
- Work with IT partners to create reporting in analytic tools such as Power BI. Understand both technical and business need to create stellar reporting that answers important business questions
- Perform analytics and reporting on existing and new programs
- Conduct studies on the value of existing and potential interventions and clinical programs – both to optimize our clinical models, as well as for use in marketing materials
- Enhance predictive analytics and proprietary clinical algorithms to optimize outcomes
- Apply a healthy balance of creative thinking and actuarial discipline in the development of core actuarial processes and analytics
- Identify overall drivers of emerging results and communicate clearly and succinctly to a non-technical audience
- Develop and maintain strong working relationships with key stakeholders including market leadership, physician and clinical operations leadership, IT, the revenue optimization team, and finance peers
- Ready to build new tools and capabilities in a new organization; show great initiative combined with the knowledge of when to ask for guidance
- Manage several fast-paced projects with an ability to produce quality materials within tight timeframes
- Integrate actuarial industry standards and external trend information to help ConcertoCare develop prospective and target performance levels
- Identifying root causes and data quality issues and working collaboratively with IT on fixes
Skills
- Progress towards Associate of the Society of Actuaries (ASA)
- 2-5 years of experience in the healthcare actuarial field with a strong understanding of health insurance product design (ideally Medicare and Medicaid), reserving/forecasting, Medicare bid pricing
- Proficient in Excel, Databricks, SQL, SAS or other coding language
- Bachelor's degree in actuarial studies, statistics, or related field preferred
- Value-based contracting modelling experience strongly preferred
- Experience in Government health care contracts preferred (Medicare and Medicaid)
- AI experience: extra consideration given to candidates who have demonstrated effective use of AI tools
Benefits
- Annual bonus
- Full healthcare coverage
- A 401K with match
- A broad range of other health, wellness, and financial benefits
Company Overview