Actuarial Analytics Director - Alternative Payment Models
Pay
Pay Range: $160,000.00 - $266,500.00
Benefits
Flexible work arrangements including remote and hybrid opportunities and paid time off.
Tuition reimbursement and assistance with student-loan repayment.
Health, dental, and vision insurance.
Programs supporting mental health and well-being.
Competitive pay, bonuses, and investment plans.
Paid time to volunteer.
Qualifications
- Bachelor’s degree in Mathematics, Statistics, Economics or related field; or a combination of education and related work experience
- ASA or FSA designation from the Society of Actuaries
- Seven to ten years actuarial experience within the health insurance or related industry
- Prior experience pricing and evaluating alternative funding arrangements in healthcare
- Medicare Advantage background
- Proven track record of partnering with finance and contracting functions to drive business results
- Strong analytical, communication, and collaboration skills
- Ability to present and translate complex data into digestible information
Skills
- Experience with provider contracting
- Experience with risk adjustment
- Experience with financial modeling
Responsibilities
Lead actuarial support for provider contracting, including feasibility analysis of proposed alternative payment models and contract structures.
Model financial impacts to inform contract negotiations, network shifts, and proposed changes.
Forecast and monitor shared savings/losses, settlement outcomes, and downstream impacts of contracting decisions.
Support risk adjustment projections and financial modeling across submission cycles to inform revenue forecasting and planning.
Analyze and forecast quality incentive payments and rebate revenue based on utilization trends and contract terms.
Collaborate with finance to ensure actuarial outputs are integrated into financial planning models and ledger entries.
Identify and explain variance drivers from new membership and provider performance throughout the year.
Perform other duties as assigned.