[Remote] Manager, Actuarial Services at Imagine Pediatrics

United States

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Not SpecifiedCompensation

Senior (5 to 8 years), Expert & Leadership (9+ years)Experience Level

Full TimeJob Type

UnknownVisa

Healthcare, Pediatrics, MedicaidIndustries

Requirements

Associate or Fellow of the Society of Actuaries
Bachelor’s degree
Minimum of 5 years of health actuarial experience, experience with value-based reimbursement strategies and affordability initiatives preferred
Minimum of 2 years of Medicaid managed care experience
Experience negotiating Medicaid managed care capitation rates is strongly preferred
Prior leadership experience is preferred but not required
Ability and willingness to train and transfer knowledge to junior level staff
Actuarial knowledge of best practices for evaluation, modeling (cost, risk score and revenue) and analytics
Strong SQL skills
Ability to work effectively in a dynamic and fast-paced environment
Strong communicator (both written and verbal) with an ability to break down complex and technical concepts in an easy-to-understand way
Strong organizational, documentation and problem-solving skills
Strong business acumen and interpersonal skills

Responsibilities

Manage and develop the processes and internal capabilities necessary to measure performance of value-based / shared savings arrangements and communicate valuable insights to key stakeholders
Manage monthly development and application of IBNR estimates
Partner with the Healthcare Economics (claims data analytics) team to demonstrate value our clients achieve with Imagine through the reporting of revenue / risk score trends, healthcare utilization trends, and financial savings
Analyze profitability by duration, acuity, and resource allocation to inform strategic recommendations to senior leadership
Work closely with other finance teams to monitor performance against forecasts, analyzing and explaining drivers of variances from revenue, cost, and membership
Prepare analyses for shared savings settlement discussions with payer partners

Skills

Key technologies and capabilities for this role

Actuarial AnalysisIBNR EstimatesValue-Based CareShared SavingsHealthcare EconomicsClaims Data AnalyticsFinancial ReportingProfitability AnalysisRisk AdjustmentMedicaidVariance Analysis

Questions & Answers

Common questions about this position

What qualifications are required for the Manager, Actuarial Services role?

Candidates must have an Associate or Fellow of the Society of Actuaries designation, a Bachelor’s degree, minimum 5 years of health actuarial experience, and minimum 2 years of Medicaid managed care experience. Preferred qualifications include experience with value-based reimbursement strategies, negotiating Medicaid managed care capitation rates, and prior leadership experience.

What are the key responsibilities of this position?

The role involves managing actuarial processes for value-based care savings, monthly IBNR estimates, partnering with Healthcare Economics for reporting on revenue trends and savings, analyzing profitability, monitoring forecasts with finance teams, and preparing analyses for payer discussions.

What technical skills are needed for this job?

Strong SQL skills are required, along with actuarial knowledge of best practices for evaluation, modeling (cost, risk score, and revenue), and analytics.

Is leadership experience required for this role?

Prior leadership experience is preferred but not required, with ability and willingness to train and transfer knowledge to junior level staff also needed.

What is the salary or compensation for this position?

This information is not specified in the job description.

Imagine Pediatrics

24/7 virtual pediatric care and support

About Imagine Pediatrics

Imagine Pediatrics offers 24/7 virtual pediatric care customized for children with medical complexity, providing unlimited access to care via messaging, phone call, or video visit, and coordinating with the child's existing care team. Their multidisciplinary team of pediatricians, nurses, social workers, and care coordinators delivers high-quality, virtual-first care and support, with services currently available in Texas and Florida.

220 Athens Way #240, Nashville, TN 37228, USAHeadquarters

2022Year Founded

$5MTotal Funding

SEEDCompany Stage

51-200Employees