Address
Form of work
SalaryCompany:
AHI agilon health, inc. Job Posting Location:
Remote - USA Job Title:
Actuarial Manager, Medicare Innovation Models Job Description:
Position Summary:
The Actuarial Manager, Medicare Innovation Models will lead a team of analyst(s) in preparing revenue projections and setting monthly reserve estimates for the ACO REACH and MSSP populations. He/she will remain aware of legislation changes impacting the ACO REACH and MSSP programs and will inform the annual budget/quarterly forecasts. The Actuarial Manager will help to educate market leaders on program nuances and drivers of prior period development. Additionally, he/she will support the build-out of improved models and processes for the actuarial team.
Essential Job Functions:
- Lead and support a team of analyst(s) working on CMS value-based payment models
- Stay apprised of legislation changes impacting the ACO REACH and MSSP programs
- Share knowledge of these programs and educate market leaders on program mechanics
- Collaborate with Medicare Innovation Model strategic leadership
- Build out actuarial models for MSSP program evaluation
- Inform revenue projections and monthly reserve setting assumptions
- Identify drivers of trend and prior period development
- Join market level managers in presentation of close results to Market Finance
- Inform annual budget/quarterly forecasts
- Provide guidance on business development assumptions for new or existing markets and Medicare models
- Support build-out of improved actuarial team processes
- Review CMS final reconciliation reports
- Review internal/external audit documentation
- Other duties as assigned
Other Job Functions:
- Grow and lead talent
- Exemplify companies’ core values
- Collaborate with Market Finance, FP&A, Accounting, Med Econ, and others
- Identifies critical issues and recommends solutions to business problems.
- Sets team objectives for assigned unit/area aligned with goals set by upper management
- Performs complex tasks typically following current established processes, while supporting the implementation of and adherence to new and/or evolved processes
Required Qualifications:
Minimum Experience
- 5+ years of actuarial experience
- Demonstrated leadership capability, has previously led others
Education/Licensure
- ASA or FSA designation
- Bachelor’s degree in Actuarial Science, Math, Economics or related field
Knowledge, Skills, and Abilities:
- Excellent communication, both written and verbal
- Strong understanding of CMS payment models and the reconciliation process
- Understanding of CMS provided data (membership, claims, revenue) and reports
- Experience with reserving and forecasting
- Experience with value-based arrangements is a plus
- Proficiency with Excel and SQL
- Proven ability to work in a fast-paced environment where internal/external client satisfaction is key
- Experience presenting actuarial/financial concepts to a non-technical audience
- Proven problem solving skills (identification of issue, causes, solution, implementation plan)
- Proven ability to influence, grow, and motivate others
- Entrepreneurial and innovative spirit
Location:
Remote - TX Pay Range:
$129,700.00 - $162,100.00 Salary range shown is a guideline. Individual compensation packages can vary based on factors unique to each candidate, such as skill set, experience, and qualifications.
