Manager, Actuarial
3 weeks ago
Full-time
Description
The Why Behind Wellvana:
The healthcare system isn't designed for health. We're designed to change that.
We're Wellvana, and we help doctors deliver life-changing healthcare.
Through our high-touch approach to value-based care, we're moving beyond fee-for-service and helping tie the healthy outcomes of patients directly to healthier profitability for primary care physicians, payors and health systems.
Physicians and health systems in our curated network retain full ownership while Wellvana takes on all the upfront risk, investing capital, people-power and customized medical management strategy to help each provider flourish on their path to full-risk value-based care.
We provide turnkey support to clinicians to reduce their administrative headaches and help them spend more time with patients. Patients, in turn, get an elevated experience with coordinated care that is nothing short of life changing.
Named a Best Place to Work by Nashville Business Journal and featured in Insider's 33 startups "investors expect to take off in 2023," we're one of the fastest-growing companies in America because what we do works.
This is the way medicine is meant to be.
Clarity on the Role:
The Manager, Actuarial, will work closely with Wellvana's actuarial, finance and analytics team in the development of value-based care insights supporting our vision, strategic direction, and performance. Scope of duties will include but not be limited to medical and pharmacy expense analyses, pre-sales analytics, underwriting, actuarial forecasting, and population health management analyses. This role consults and collaborates with leadership regarding financial results and forecasting. This position will be key in supporting the business to meet financial objectives by identifying and quantifying opportunities and risks, through key root-cause analyses, and providing recommendations. The role will need to be able to successfully work within a complex but nimble environment. This position will work closely with and report to the Sr. Director, Actuarial.
What's Expected:
- Execute on the strategy and manage actuarial accrual and trend analytic activities, medical and pharmacy data collection and perform ad-hoc analyses
- Be a subject matter expert in Medicare Advantage and ACO REACH
- Identify, design, and execute analytics to uncover critical business insights that facilitate improved business decisions for senior leadership; analytics may include actuarial, HCE and/or data science related solutions
- Present findings in clear, compelling manner to senior leadership to provide information needed supporting decision-making
- Measure and project savings for new and existing affordability initiatives and recommend new initiatives in collaboration with clinical leadership
- Quantify impact of policy reform, population shifts, etc. on existing products and customer arrangements
- Project medical expense for forecasting purposes and monitor variance to budget
- Serve as resource to Actuarial leadership
- Prepare and provide supporting documentation for actuarial liabilities included in the company's financial statements
- Communicate results, findings, and recommendations to the organization
- Demonstrate understanding of applicable laws and regulations as well as the actuarial code of conduct and actuarial standards of practice
- Program and analyze key reports related to Actuarial initiatives
What's Required:
- Integrity: The right way is the only way.
- Dependability: You do what you say you're going to do.
- Advocacy: You fight for the best possible outcome for providers and their patients.
- Clarity: You make it all understandable.
- Bachelor's degree
- ASA or FSA preferred
- 5+ years of actuarial experience
- 5+ years direct experience with healthcare data and analytics
- 3+ years of project ownership experience
- Must have successfully passed actuarial exams
- Extensive knowledge of Medicare healthcare industry and trends; medical, pharmacy/Part D, SDoH, behavioral health experience especially valuable
- Superior conceptual, analytical, financial modeling, and problem-solving skills
- Act as a trusted advisor to key stakeholders throughout the organization
- Ability to effectively communicate with various levels of staff
- Strong interpersonal and relationship building skills to support collaboration at all levels of the organization
- Openly and actively communicate information and take initiative to communicate extensively
- Excellent written, verbal, presentation, and negotiation skills
- Medicare Advantage Part C and D bid development expertise
- Highly effective written, oral, and persuasive communication skills
- Develop, translate and execute strategies or functional objectives for the business
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