OverviewOur 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.
ResponsibilitiesPosition 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, providing 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 RangeUSD $130,000.00 - USD $150,000.00 /Yr.
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