VP, Actuarial Services

1 month ago

Trenton, United States Careabout Full time

Company Description CareAbout Health is a managed services organization (MSO) that provides expert advice, resources, tools, and other support to its portfolio of medical groups and healthcare focused companies. CareAbout Health is helping align incentives to create a world where patients, providers, and payers work together in a seamless, coordinated manner toward common goals: higher quality, lower cost, better outcomes. Role Title:

VP, Actuarial Services FLSA Category:

Exempt Role Location:

NY Office, Hybrid Reporting Relationships: This position reports to CareAbout Health’s Chief Financial Officer. Role Summary and Responsibilities: We are seeking a highly skilled and analytical Vice President of Actuarial Services with experience in Medicare Advantage and or ACO programs. The ideal candidate will lead our actuarial capabilities, providing strategic direction and ensuring the accuracy and reliability of all actuarial analyses. This role requires a visionary leader with a strong technical background and the ability to influence and drive organizational goals. Key Responsibilities / Essential Functions: Lead the actuarial area in the development and execution of actuarial models and analyses specific to Medicare Advantage and ACO programs, while growing capabilities in commercial and Medicaid. Oversee the preparation of actuarial reports, financial projections, and risk assessments. Provide strategic direction and insights to senior management regarding actuarial, financial, and business matters. Ensure compliance with all regulatory requirements and industry standards, particularly those related to Medicare Advantage and ACOs. Collaborate with other departments to support business initiatives and enhance decision-making processes. Mentor and develop financial analytical staff in actuarial sciences fostering a culture of continuous learning and professional growth. Work closely with Medical Economics in analyzing and forecasting medical utilization and in analyzing the impact of cost of care efforts Stay abreast of industry trends and advancements in actuarial science to maintain the company's competitive edge. Analyze and interpret complex data sets to provide actionable insights for improving patient outcomes and reducing costs. Develop and implement financial strategies to optimize revenue and manage risk. Determine how our VBC contracts will be impacted by revenue and medical expense trends and regulatory changes Actively participate in day-to-day operations, including data analysis, report generation, and other hands-on tasks as needed. Understand the dynamics of Medicare and commercial risk scores Foster a collaborative environment where team members are encouraged to share ideas and contribute to the company's success. Non-Essential Functions Other duties, as assigned. Qualifications Bachelor’s degree in Actuarial Science, Mathematics, Statistics, or a related field; Master’s degree preferred. Fellowship in the Society of Actuaries (FSA) or equivalent professional designation. Minimum of 10 years of actuarial experience, with at least 5 years in a leadership role within Medicare Advantage and/or ACO programs. Proven track record of developing and implementing successful actuarial strategies. Strong analytical, problem-solving, and decision-making skills. Comprehensive knowledge of Medicare Advantage and or ACO regulations and requirements. In-depth understanding of Medicare Advantage bid preparation and ACO benchmarking processes. Excellent communication and interpersonal skills, with the ability to convey complex information to non-technical stakeholders. Experience with actuarial software and advanced proficiency in statistical and data analysis tools. A willingness to roll up your sleeves and engage in hands-on tasks to support the team. Ability to thrive in a fast-paced, small company environment and manage multiple priorities Physical Requirements Mainly sedentary. Sitting at the desk most of the day. Standing or walking less than two hours per day. Lifting no more than ten pounds on rare occasions. Must be able to work at a computer and answer phone calls on a regular basis. Compensation is based on the level and requirements of the role. Salary within our ranges may also be determined by your education, experience, knowledge, skills, abilities, and location, as required by the role, as well as internal equity and alignment with market data. CareAbout Health is committed to providing an environment of mutual respect where equal opportunities are available to all applicants and employees without regard to actual or perceived race, color, creed, religion, national origin, ancestry, citizenship status, age, sex or gender (including pregnancy, childbirth, related medical conditions and lactation), gender identity or gender expression (including transgender status), sexual orientation, marital status, military service and veteran status, disability, protected medical condition as defined by applicable state or local law, genetic information, or any other characteristic protected by applicable federal, state, or local laws and ordinances (referred to as “protected characteristics”). We are interested in every qualified candidate who is legally able to work in the United States without sponsorship. We cannot offer any visa sponsorship now at this time.

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