Actuarial Services Manager

Overview

Our mission is Better Health. Our passion is helping others.

What's Your Why?

• Are you looking for a career opportunity that will help you grow personally and professionally?

• Do you have a passion for helping others achieve Better Health?

• Are you ready to join a growing team that shares your mission?

Why Join Our Team: At Better Health Group, it's our commitment, our passion, and our culture that sets us apart. Our Team Members make a difference each and every day! They support our providers and payors, ensuring they have the necessary tools and resources to always deliver best-in-class healthcare experiences for our patients. We don't just talk the talk - we believe in it and live by it. Be part of a team that shares your passion and drive, and start living your purpose at Better Health Group.

Responsibilities

Position Objective:

The Actuarial Services Mgr is an administrative role and is responsible for developing medical reserving methodologies, actuarial forecasts, and assessing financial risk and opportunity to the organization.

Responsibilities:

• Utilize data analytics and business intelligence tools to conduct in-depth analysis, and financial forecasting, and provide actionable insights to support decision making
• Build and maintain IBNR reserving models across Medicare Advantage, Medicaid, and Medicare ACO lines of business
• Develop long-range revenue and medical forecasts based on analysis of Company and Industry data
• Evaluate and update risk adjustment forecast and accrual model for mid-year and final-year true-ups
• Identify opportunities for cost containment and efficiency improvement within healthcare operations
• Analyze healthcare utilization patterns and work with medical management teams to identify opportunities for optimization and resource allocation improvements
• Stay up-to-date with healthcare industry regulations, market trends, and changes in reimbursement policies
• Work closely with executive leadership, medical economics, health services, finance, and other departments to align strategies with broader organizational goals
• Additional duties as assigned

Position Requirements/ Skills:

• Bachelor's Degree required
• ASA or FSA designation
• Minimum of 5 years of progressive actuarial experience, preferably with Medicare Advantage bid submission experience and/or Medicare ACO experience
• Strong knowledge of healthcare regulations, policies, and industry trends
• Familiarity with healthcare reimbursement methodologies, payer contracts, and provider payment systems
• Proficient in various data analytics software and tools such as SQL, PowerBI, PowerPivot, PowerQuery, VBA, Macros
• Proficient with Google Suite (Drive, Docs, Sheets, Slides) and Microsoft Office (Word, Excel, PowerPoint) for real-time collaboration

Physical Requirements:

• Ability to sit for extended periods of time
• Ability to operate a motor vehicle

Key Attributes/ Skills:

• Has a contagious and positive work ethic, inspires others, and models the behaviors of core values and guiding principles
• An effective team player who contributes valuable ideas and feedback and can be counted on to meet commitments
• Is able to work within our Better Health environment by facing tasks and challenges with energy and passion
• Pursues activities with focus and drive, defines work in terms of success, and can be counted on to complete goals
• Demonstrated ability to handle data with confidentiality
• Ability to work cross-functionally with multiple teams; ability to work independently with minimal supervision
• Excellent organizational, time-management, and multi-tasking skills with strong attention to detail
• Excellent written and verbal communication skills; must be comfortable communicating with internal and external stakeholders
• Strong interpersonal and presentation skills
• Strong critical thinking and problem-solving skills
• Must be results-oriented with a focus on quality execution and delivery
• Appreciation of cultural diversity and sensitivity toward target patient populations

compensation & Benefits:

• We offer competitive compensation and comprehensive benefits package:
• Competitive base salary with bonus potential upon placement/retention
• Medical, dental, vision, disability and life
• 401k, with employer match
• Paid time off
• Paid holidays

Pay Range

USD $130,000.00 - USD $150,000.00 /Yr.