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Actuarial Consultant

1 month ago

Dallas, United States Signify Health Full time
Job DescriptionJob Description

How will this role have an impact?

Signify Health/CVS Accountable Care is seeking a highly motivated and experienced actuary to join our fast-growing organization. The actuary will be a key person on the CVS Accountable Care team in supporting the business to meet financial objectives by identifying and quantifying opportunities and risks, through key root-cause analyses, and manage the risk position of various value-based products (MSSP, ACO REACH, Medicare Advantage, Commercial).

The successful candidate will have strong knowledge of and deep expertise in working with large Medicare claims dataset, conducting actuarial and risk adjustment (CMS-HCC) analysis. In addition, the position will contribute significantly to project and client management. The role will need to be able to successfully work within a matrix and nimble environment.

What will you do?
  • Develop analytics strategies to drive performance for our partners and ACOs through the use of actuarial and advanced analytics techniques
  • Proactively identify areas of opportunities for improvement and actionable insights for our partners and our ACOs using claims and real-time data.
  • Evaluate the impact of Medicare quality and risk adjustment program has on our MA risk contracts and ACOs (MSSP and ACO REACH), including but not limited to risk adjustment opportunities, HCC gaps, and benchmarking analysis.
  • Build models to help CVS Accountable Care identify areas to improve utilization of healthcare services
  • Develop the appropriate level of reserves and analyze claims completion patterns for our ACOs
  • Conduct descriptive and predictive analyses to identify opportunities to target population health interventions, improve care delivery, contribute to product and services development, and inform CVS Accountable Care's growth strategy
  • Analyze various sources of patient care and claims data, including 100% Medicare data or VRDC, to provide actionable insights to stakeholders
  • Get up to speed on our data model and make recommendations for changes to improve the accuracy and efficiency of the monthly claims completion process
  • Proactively identify and communicate issues affecting a project plan
  • Prepare comprehensive documented observations, analyses and interpretations of results including technical reports, summaries and quantitative analyses
  • Present analysis results to internal and external audiences, including company executives, subject matter experts, delivery teams, and clinical teams within Signify Health/ CVS Accountable Care
We are looking for someone with:
  • Bachelor's Degree or higher in Mathematics, Statistics, Actuarial Science or closely related field.
  • 2-5 years of relevant industry experience in one or more of the following areas:
    • Medicare Advantage, ACO, MSSP, ACO REACH
    • Healthcare Economics
    • Pricing
    • Reserving
    • Forecasting
    • Data Analytics
  • Excellent quantitative analysis abilities, grounded in epidemiology, biostatistics, econometrics, health informatics, healthcare analytics or related field.
  • Strong SQL, SAS, Python, or R skills, ability to perform effective querying involving multiple tables and subqueries.
  • Demonstrated ability to conduct nuanced analyses to produce accurate and unbiased results and tell the story of those results in data visualizations and reports.
  • Deep knowledge of standard methods for measuring health care utilization, spending, quality, and outcomes; risk adjustment; provider profiling; and related analytical tasks.
  • Examine, interpret and report results of analytical initiatives to stakeholders.
  • Excellent oral and written communication skills; ability to present complex information in an understandable and compelling manner
  • Ability to work independently and in team environment
  • Proven ability to work in a fast-paced environment where client satisfaction is key
  • Preferred Qualifications:
    • Attainment, or close to the attainment, of Associate of the Society of Actuaries (ASA)
    • Experience with VRDC (CMS 100% Research Identifiable Files RIF) and/or LDS (5% Sample Data)
    • Prior experience in value-based care settings.
    • Proficient in Excel, Word and Power Point software

The base salary hiring range for this position is $72,100 to $125,600. Compensation offered will be determined by factors such as location, level, job-related knowledge, skills, and experience. Certain roles may be eligible for incentive compensation, equity, and benefits.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. Eligible employees may enroll in a full range of medical, dental, and vision benefits, 401(k) retirement savings plan, and an Employee Stock Purchase Plan. We also offer education assistance, free development courses, paid time off programs, paid holidays, a CVS store discount, and discount programs with participating partners.

About Us:

Signify Health is helping build the healthcare system we all want to experience by transforming the home into the healthcare hub. We coordinate care holistically across individuals' clinical, social, and behavioral needs so they can enjoy more healthy days at home. By building strong connections to primary care providers and community resources, we're able to close critical care and social gaps, as well as manage risk for individuals who need help the most. This leads to better outcomes and a better experience for everyone involved.

Our high-performance networks are powered by more than 9,000 mobile doctors and nurses covering every county in the U.S., 3,500 healthcare providers and facilities in value-based arrangements, and hundreds of community-based organizations. Signify's intelligent technology and decision-support services enable these resources to radically simplify care coordination for more than 1.5 million individuals each year while helping payers and providers more effectively implement value-based care programs.

To learn more about how we're driving outcomes and making healthcare work better, please visit us at www.signifyhealth.com

Diversity and Inclusion are core values at Signify Health, and fostering a workplace culture reflective of that is critical to our continued success as an organization.

We are committed to equal employment opportunities for employees and job applicants in compliance with applicable law and to an environment where employees are valued for their differences.