Dallas, TX
$92,300/yr - $160,800/yr Remote Full-time Mid-Senior level
1,001-5,000 employees · Hospitals and Health Care
Our consultants are seeking a highly motivated and experienced actuary to join our fast-growing organization. The actuary will be a key person on the Accountable Care team that analyzes various sources of patient health and claims data to help the business understand, forecast and manage the risk position of various value-based products (MSSP, ACO REACH, Medicare Advantage).
The successful candidate will have strong knowledge of and deep expertise in working with large Medicare claims dataset, conducting actuarial and risk adjustment (CMS-HCC) analysis. In addition, the position will contribute significantly to project and client management.
What will you do?
Evaluate the impact of Medicare quality and risk adjustment program has on our MA risk contracts and ACOs (MSSP and ACO REACH), including but not limited to risk adjustment opportunities, HCC gaps, and benchmarking analysis.
Build models to help Accountable Care identify areas to improve utilization of healthcare services
Assist with model development for identifying and implementing clinically viable tools and initiatives for provider behavior change
Conduct descriptive and predictive analyses to identify opportunities to target population health interventions, improve care delivery, contribute to product and services development, and inform Accountable Care’s growth strategy
Analyze various sources of patient care and claims data, including 100% Medicare data or VRDC, to provide actionable insights to stakeholders
Get up to speed on our data model and make recommendations for changes to improve the accuracy and efficiency of the monthly claims completion process
Proactively identify and communicate issues affecting a project plan
Prepare comprehensive documented observations, analyses, and interpretations of results including technical reports, summaries and quantitative analyses
Present analysis results to internal and external audiences, including company executives, subject-matter experts, delivery teams, and clinical teams within the organization
We Are Looking For Someone With
Bachelor’s Degree or higher in Mathematics, Statistics, Actuarial Science or closely related field.
Attainment, or close to the attainment, of Associate of the Society of Actuaries (ASA)
4-9 years of relevant industry experience in one or more of the following areas:
Medicare Advantage, ACO, MSSP, ACO REACH
Healthcare Economics
Pricing
Reserving
Forecasting
Data Analytics
Excellent quantitative analysis abilities, grounded in epidemiology, biostatistics, econometrics, health informatics, healthcare analytics or related field.
Strong SQL, SAS, Python, or R skills, ability to perform effective querying involving multiple tables and subqueries.
Demonstrated ability to conduct nuanced analyses to produce accurate and unbiased results and tell the story of those results in data visualizations and reports.
Deep knowledge of standard methods for measuring health care utilization, spending, quality, and outcomes; risk adjustment; provider profiling; and related analytical tasks.
Examine, interpret and report results of analytical initiatives to stakeholders.
Excellent oral and written communication skills; ability to present complex information in an understandable and compelling manner
Ability to work independently and in team environment
Proven ability to work in a fast-paced environment where client satisfaction is key
Preferred Qualifications:
Master’s Degree or higher in Mathematics, Statistics, Actuarial Science or closely related field.
Attainment of the Fellowship of the Society of Actuaries (FSA)
Experience with VRDC (CMS 100% Research Identifiable Files RIF) and/or LDS (5% Sample Data)
Prior experience in value-based care settings.
Proficient in Excel, Word, and PowerPoint software
The base salary hiring range for this position is $92,300 to $160,800. Compensation offered will be determined by factors such as location, level, job-related knowledge, skills, and experience. Certain roles may be eligible for incentive compensation, equity, and benefits.
In addition to your compensation, enjoy the rewards of an organization that puts our heart into caring for our colleagues and our communities. Eligible employees may enroll in a full range of medical, dental, and vision benefits, 401(k) retirement savings plan, and an Employee Stock Purchase Plan. We also offer education assistance, free development courses, paid time off programs, paid holidays, discounts, and discount programs with participating partners.
TO APPLY-Please forward resume to Paul Martin at pmartin@pailingroup.com
pailingroup.com
