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Healthcare Actuarial Analytics Lead

2 months ago

Portland, Oregon, United States Phenom Consulting Full time
Job Overview

Join Our Actuarial Team

Phenom Consulting is collaborating with a prominent healthcare organization to enhance their Actuarial division. We are in search of an Actuarial Analytics Lead who possesses substantial experience within the healthcare sector.

In this managerial role, you will be responsible for directing and supervising the organization’s Medicaid and Medicare initiatives. Your duties will include leading the evaluation of capitation rate assumptions and methodologies, managing financial and encounter data submissions, offering expert guidance for Medicare bid processes, and analyzing financial performance. The ideal candidate will stay informed about the latest healthcare trends and regulations while cultivating robust relationships with both internal and external stakeholders.

Key Responsibilities:

  • Capitation Rate Management: Spearhead the analysis and assessment of capitation rate assumptions and methodologies for Medicaid.
  • Oversight of Data Submissions: Oversee the submission process for financial and encounter data to facilitate Medicaid capitation rate establishment.
  • Medicare Consultation: Provide specialized insights and support for Medicare bid processes and pricing strategies.
  • Financial Performance Assessment: Evaluate the financial results for Medicaid and Medicare business lines.
  • Continuous Learning: Remain updated on evolving healthcare trends, actuarial regulations, governmental guidelines, analytical techniques, and data sources.
  • Building Relationships: Establish and nurture strong connections with leadership across various departments, including Product, Finance, Regulatory, and Pharmacy, as well as with external entities.
  • Leadership Development: Mentor team members and prioritize their tasks and projects.

Qualifications:

  • Educational Credentials: Bachelor’s Degree in Statistics, Computer Science, Mathematics, Social Science, or a related discipline.
  • Professional Experience: At least 5 years in healthcare actuarial positions with a focus on Medicare Advantage pricing and bid development.
  • Technical Proficiency: Skilled in writing queries in SQL or other programming languages.
  • Project Management Expertise: Demonstrated ability to apply project management skills in data-centric and financial analysis initiatives.

Preferred Attributes:

  • Advanced Degree: Master’s Degree in Statistics, Computer Science, Mathematics, Social Science, or a related field.
  • Professional Credentials: Fellow or Associate in the Society of Actuaries (FSA or ASA).
  • Medicare Advantage Knowledge: Experience in certifying Medicare Advantage Bids.
  • Revenue Methodology Familiarity: Understanding of Commercial, Medicare, and Medicaid revenue methodologies.
  • Leadership Skills: Proven ability to manage professional staff who independently execute tasks and projects.

What We Offer:

  • Flexible remote work options available.
  • Comprehensive benefits package including medical, dental, wellness, retirement, and career development opportunities.
  • Opportunity to play a pivotal leadership role in a dynamic organization.
  • Competitive salary and total compensation package.

If you are an experienced Actuarial Leader looking to take on a significant role within a leading organization, we encourage you to consider this opportunity.