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![Better Health Group](https://media.trabajo.org/img/noimg.jpg)
Actuarial Services Manager
2 months ago
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.
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