Client looking to add a Director level health actuary. Job can be fully remote. This position will be:
Responsible for being the SME (Subject Matter Expert) and analytics lead for Medicare Risk Adjustment programs.
Key member of Medicare leadership team.
Responsibility includes support/influence and partner with the Medicare line of business leadership and RA operational leadership. Responsible for projection of RA results; understanding actual results vs expected, identifying risks and opportunities.
Oversee maintenance of SQL model, estimate risk scores, and analyze impact.
Extract, analyze, and synthesize data from various sources to identify risks and opportunity.
Effectively communicate results and risks to senior management.
Position is within the Performance Analytics team of firm's Actuarial organization.
Lead the design and performance of studies related to risk scores and trends.
Document assumptions and methodologies.
Support ad-hoc projects related to operations, rate filings, new business development, financial projections, budgeting, and acquisitions.
Provide technical guidance and leadership to staff.
Advise on bid items related to risk adjustment.
Design and program reports to support operations, pricing, and financial reporting.
Review reporting prepared by others to assure consistency and appropriateness of methodologies used.
Interpret results and prepare executive summaries to recommend solutions to identified issues.
Stay abreast of professional developments and industry trends.
Looking for 6+ years of relevant experience.