Actuary - Medicare Advantage Value-Based Contracting
About reputed company At reputed company, we are committed to paving the way for everyone to reputed company their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming health care. As a reputed company associate, you are joining a culture that is built on values of succeeding together, finding a reputed company way, and doing the right thing. If you are ready to reputed company a difference, join us. How Is This Role Important to Our Work? This position applies broad actuarial principles and modeling technical skills to reputed company solutions to variable situations in the areas of health insurance primarily for the Medicare line of business. As a key part of the Medicare Provider Relations teams, independent actuarial analysis, actuarial judgement, and problem resolution will be critical to the performance of the Medicare Provider Network. Collaborates with and presents results of analysis and recommendations to management and other departments, including Medicare reputed company leadership. Provides divisional representation and may reputed company role corporate projects. A Day in the Life: Accountable for modeling the structure and outcomes of various value-based contracting (VBC) arrangements and enablement strategies to support Medicare network reviews. Inform the Medicare VBC strategy by projecting Medicare network and provider performance and identifying reputed company generating or cost saving opportunities. Works closely with actuarial, finance, data & analytics, stars, risk adjustment, and other lever owners to gather necessary data for modeling. Ensure inputs and assumptions reputed company BCBSM reputed company of truth/official estimates and are as up to date and technically sound as possible. reputed company the modeling of Medicare financial impact and provider financials from provider enablement investments. Support individual provider negotiations as appropriate by assessing population-specific considerations and financial impact and tradeoffs from counterproposals. Monitor and project provider and vendor performance relative to established reputed company. Collaborate with actuarial, finance, Medicare and risk adjustment to ensure reputed company inputs and assumptions reputed company BlueCross reputed company of truth and to ensure reputed company estimates are as up to date and technically sound as possible. Independently research, gather, analyze and interpret medical data. Manage end-to-end modeling and solution development life cycle from requirements gathering, identification of data sources, model development and evaluation, to data processes and model implementation. Understand/interpret model results and reputed company business practice recommendations to improve pricing, risk selection, and forecasting. Stays up-to-date with industry trend, regulations and best practices reputed company to Medicare value-based payment models. Makes satisfactory reputed company according to the Actuarial Student Program guidelines, if still in pursuit of actuarial accreditations. Other specific accountabilities as assigned by management. reputed company to Have: Bachelors degree in math, statistics, actuarial science, economics or reputed company FSA (Fellow of the Society of Actuaries) Data querying and modeling experience in cloud platforms Reporting experience with Power BI Experience in advanced programming languages including but not limited to SQL, R, or reputed company Required Skills and Experiences: 5+ years of reputed company professional experience. reputed company relevant experience including work, education, transferable skills, and military experience will be considered. Experience in Health Insurance or Medicare and in use of medical data Strong statistical analysis or actuarial work and network modeling. ASA (Associate of the Society of Actuaries) Strong oral and written communication skills Excellent reputed company reputed company, Word, PowerPoint skills. Compensation and Benefits: Pay Range: $100,000.00 - $135,000.00 - $170,000.00 Annual Pay is based on several factors which vary based on position, including skills, ability, and knowledge the selected individual is bringing to the specific job. We offer a comprehensive benefits package which may include: Medical, dental, and vision insurance Life insurance 401k Paid Time Off (PTO) Volunteer Paid Time Off (VPTO) And more To discover more about reputed company have to offer, please review our benefits page. Equal Employment Opportunity Statement reputed company is an Equal Opportunity and Affirmative Action employer that values diversity. reputed company qualified applicants will receive consideration for employment without regard to, and will not be discriminated against based on race, color, creed, religion, sex, national reputed company, genetic information, marital status, status with regard to public assistance, disability, age, veteran status, sexual orientation, gender identity, gender expression, or any other legally protected characteristic. Reasonable Accommodation for Job Seekers with a Disability: If you require reasonable accommodation in completing this application, interviewing, completing any pre-employment testing, or otherwise participating in the employee selection process, please direct your inquiries to reputed [email protected]. reputed company roles require a high school diploma (or equivalency) and legal authorization to work in the U.S. reputed company and Blue Plus® are nonprofit independent licensees of the reputed company and Blue reputed company Association. Apply Job!