Preferred Locations – MN, AZ, TX, FL

SCOPE OF ROLE

The Senior Actuarial Analyst – Provider Risk will support actuarial workflows in the area of ACO REACH performance evaluation and forecasting. In addition, this role supports value-based contracting (VBC) work to include evaluation and forecasting of full and partial risk arrangements between NeueHealth affiliated providers and payors from multiple LOBs (Commercial, Medicare Advantage, Medicaid, etc.). Additional cross-functional support role working with Line of Business, Analytics, Finance, Marketing and other areas of the company that may need data summarization, modeling framework or research help.

ROLE RESPONSIBILITIES

• Support monthly medical expense reserving and forecasting processes

• Support the Provider Risk team’s development of actuarial models (creating, testing, and maintaining)

• Assist in the evaluation of financial implications of provider participation in networks for ACO REACH opportunities

• Assist in the provider risk contract evaluation work and ACO REACH performance evaluations, interfacing with internal Bright team and external consulting actuaries

• Collaborate with Finance team in the development of forecasting models, projections and relevant information to inform C-Level business decisions

• Support the development of contract analysis assumptions to inform contract evaluation decisions and plan benefit development and provide guidance to the NeueHealth and owned clinics teams

• Perform ad-hoc data analysis using Excel, SAS, SQL (Databricks)

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

• Bachelor’s degree required in Math, Statistics, Economics, Actuarial Science, or a related field

• 1+ years of actuarial experience working within healthcare is required

• Must have passed at least two actuarial exams (required)

• Experience working with a CMMI ACO Model (of any kind) is preferred

• Experience working with health claim reserving (lag development) is preferred

PROFESSIONAL COMPETENCIES

• Proficient in Microsoft Excel based models (VBA, advanced data visualization, etc.) and other Office products

• Proficient with SQL and/or SAS (Databricks experience is a plus)

• Understanding of company practices related to management of member populations for purposes of estimating risk

• Produce, understand, and interpret internal and external analysis and reports; provide effective technical and non-technical support to internal and external stakeholders

LICENSURES AND CERTIFICATIONS

• Working toward Associate of the Society of Actuaries is strongly preferred, but not required if experience strongly aligns to role needs.

WORK ENVIRONMENT

The majority of work responsibilities are performed in an open office or remote home setting, carrying out detailed work sitting at a desk/table and working on the computer. Some travel may be required.

$60,000 — $90,000/year