Actuarial - Healthcare Economist

The Actuarial – Healthcare Economist at Florida Cancer Specialists & Research Institute (FCS) performs actuarial analysis pertinent to FCS businesses, including the Value-Based Care Program Portfolio and the analysis and supportive development of new alternative payment models and population health management. This individual should be proficient in actuarial science methodologies and develop / use relevant tools, databases, and record systems to gather and synthesize information for interpretation.

About the role

• Maintain working knowledge of current value-based care contracts, programs, and initiatives
• Collaborate with cross-functional teams to develop and implement value-based care models, payment structures, and reimbursement mechanisms that align with incentives for improved patient outcomes / high value care
• Conduct in-depth analysis of healthcare data, claims utilization patterns, and cost trends to inform the development of actuarial models and economic forecasts
• Provide expert guidance on healthcare policy implications, regulatory changes, and market trends that may impact value-based care strategies
• Work closely with data scientists and healthcare professionals to design and refine models for risk adjustment, cost-sharing, performance measures
• Collaborate with internal and external stakeholders to communicate complex findings in a clear and concise manner, including presentations, reports, and recommendations
• Audit the financial impact of proposed value-based care programs, utilizing actuarial methodologies and economic principles to forecast potential incentives and risks
• Develop detailed analysis, build forecasting models, and trend analysis to present to key leaders and decision makers

Responsibilities

• Maintain working knowledge of current value-based care contracts, programs, and initiatives
• Collaborate with cross-functional teams to develop and implement value-based care models, payment structures, and reimbursement mechanisms that align with incentives for improved patient outcomes / high value care
• Conduct in-depth analysis of healthcare data, claims utilization patterns, and cost trends to inform the development of actuarial models and economic forecasts
• Provide expert guidance on healthcare policy implications, regulatory changes, and market trends that may impact value-based care strategies
• Work closely with data scientists and healthcare professionals to design and refine models for risk adjustment, cost-sharing, performance measures
• Collaborate with internal and external stakeholders to communicate complex findings in a clear and concise manner, including presentations, reports, and recommendations
• Audit the financial impact of proposed value-based care programs, utilizing actuarial methodologies and economic principles to forecast potential incentives and risks
• Develop detailed analysis, build forecasting models, and trend analysis to present to key leaders and decision makers

Requirements

• Bachelor’s degree (B.A.) in actuarial science, healthcare economics, quantitative analysis, mathematics, or a closely related field; statistics background would prove helpful in this role
• Master’s degree in healthcare economics, Actuarial Science, Economics, analytics, or related field preferred
• ASA of FSA designation with ability to sign pricing and reserving opinions a plus
• Experienced healthcare economist or actuary, preferably with a large-scale payer or equivalent solution provider
• Experience with healthcare actual and underwriting functions required to successfully meet the needs of understanding organizational risk
• Proficiency in database querying tools and strong data management skills
• Strong understanding of data systems and sources and how it impacts the data available
• Working knowledge of medical claims, billing practices, and health insurance requirements
• Experience in building forecasting models and conducting budget impact analysis
• Knowledge of actuarial landscapes of payers, the value metrics they use, principal calculation methods

Qualifications

• Bachelor’s degree (B.A.) in actuarial science, healthcare economics, quantitative analysis, mathematics, or a closely related field; statistics background would prove helpful in this role
• Master’s degree in healthcare economics, Actuarial Science, Economics, analytics, or related field preferred
• ASA of FSA designation with ability to sign pricing and reserving opinions a plus
• Experienced healthcare economist or actuary, preferably with a large-scale payer or equivalent solution provider
• Experience with healthcare actual and underwriting functions required to successfully meet the needs of understanding organizational risk
• Proficiency in database querying tools and strong data management skills
• Strong understanding of data systems and sources and how it impacts the data available
• Working knowledge of medical claims, billing practices, and health insurance requirements
• Experience in building forecasting models and conducting budget impact analysis
• Knowledge of actuarial landscapes of payers, the value metrics they use, principal calculation methods

Skills

• Analysis & Critical Thinking
• Interpersonal Skills
• Time Management
• Organizational Skills
• Collaboration
• Feedback

Benefits

• Competitive salaries
• Comprehensive benefits packages
• Tuition reimbursement
• 401-K match
• Pet and legal insurance

Pay

Competitive salaries are offered based on experience and qualifications.

Schedule

Remote work is available.