Our mission is Better Health. Our passion is helping others.
What's Your Why?
Are you looking for a career opportunity that will help you grow personally and professionally?
Do you have a passion for helping others achieve Better Health?
Are you ready to join a growing team that shares your mission?
Why Join Our Team: At Better Health Group, it's our commitment, our passion, and our culture that sets us apart. Our Team Members make a difference each and every day! They support our providers and payors, ensuring they have the necessary tools and resources to always deliver best-in-class healthcare experiences for our patients. We don't just talk the talk - we believe in it and live by it. Be part of a team that shares your passion and drive, and start living your purpose at Better Health Group.
Responsibilities
Position Objective:
The Actuarial Services Mgr is an administrative role and is responsible for developing medical reserving methodologies, actuarial forecasts, and assessing financial risk and opportunity to the organization.
Responsibilities:
Utilize data analytics and business intelligence tools to conduct in-depth analysis, and financial forecasting, and provide actionable insights to support decision making
Build and maintain IBNR reserving models across Medicare Advantage, Medicaid, and Medicare ACO lines of business
Develop long-range revenue and medical forecasts based on analysis of Company and Industry data
Evaluate and update risk adjustment forecast and accrual model for mid-year and final-year true-ups
Identify opportunities for cost containment and efficiency improvement within healthcare operations
Analyze healthcare utilization patterns and work with medical management teams to identify opportunities for optimization and resource allocation improvements
Stay up-to-date with healthcare industry regulations, market trends, and changes in reimbursement policies
Work closely with executive leadership, medical economics, health services, finance, and other departments to align strategies with broader organizational goals
Additional duties as assigned
Position Requirements/ Skills:
Bachelor's Degree required
ASA or FSA designation
Minimum of 5 years of progressive actuarial experience, preferably with Medicare Advantage bid submission experience and/or Medicare ACO experience
Strong knowledge of healthcare regulations, policies, and industry trends
Familiarity with healthcare reimbursement methodologies, payer contracts, and provider payment systems
Proficient in various data analytics software and tools such as SQL, PowerBI, PowerPivot, PowerQuery, VBA, Macros
Proficient with Google Suite (Drive, Docs, Sheets, Slides) and Microsoft Office (Word, Excel, PowerPoint) for real-time collaboration
Physical Requirements:
Ability to sit for extended periods of time
Ability to operate a motor vehicle
Key Attributes/ Skills:
Has a contagious and positive work ethic, inspires others, and models the behaviors of core values and guiding principles
An effective team player who contributes valuable ideas and feedback and can be counted on to meet commitments
Is able to work within our Better Health environment by facing tasks and challenges with energy and passion
Pursues activities with focus and drive, defines work in terms of success, and can be counted on to complete goals
Demonstrated ability to handle data with confidentiality
Ability to work cross-functionally with multiple teams; ability to work independently with minimal supervision
Excellent organizational, time-management, and multi-tasking skills with strong attention to detail
Excellent written and verbal communication skills; must be comfortable communicating with internal and external stakeholders
Strong interpersonal and presentation skills
Strong critical thinking and problem-solving skills
Must be results-oriented with a focus on quality execution and delivery
Appreciation of cultural diversity and sensitivity toward target patient populations
Compensation & Benefits:
We offer competitive compensation and comprehensive benefits package:
Competitive base salary with bonus potential upon placement/retention