Actuarial Services Mgr

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