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SalaryHealth Alliance Plan (HAP) is seeking a dynamic leader as the Director, Actuarial and Healthcare Analytics. As the Director, you will play a crucial role in shaping and overseeing HAP's Medicare financials analysis, medical expense budgeting, and coordination with consulting actuaries. This is a true leader who will own Medicare strategy, lead an exceptional team, and drive profitability and growth. This is an exceptional opportunity to leverage your expertise to make a significant impact on our organization's financial success and strategic direction.
Responsibilities:
- Financial Analysis and Modeling: Lead the development and enhancement of revenue and claim estimates, encompassing critical components such as risk scores and adjustments, trend analysis, drug rebates, reinsurance recoveries, and reserves. Utilize advanced modeling techniques to provide accurate and insightful financial projections.
- Team Development: Build and mentor a high-performing team capable of managing the bid process, valuation, financial analysis, forecasting, and monitoring of results. Foster a collaborative and growth-oriented environment, empowering team members to excel in their roles and contribute to overall organizational success.
- Medicare Advantage Plan Development: Develop a proficient team to manage all technical functions required in MAPD bid filing, including but not limited to CMS desk review, CMS bid audit, and compliance. Ensure adherence to regulatory guidelines and drive excellence in the bid filing process.
- Strategic Direction: Collaborate with senior leadership to define and execute the strategic direction of the Actuarial department. Provide valuable insights and recommendations based on data analysis and actuarial expertise, contributing to the achievement of HAP's long-term goals.
- Actuarial Consultation and Collaboration: Coordinate and collaborate with consulting actuaries for rate filings, year-end certifications, and bids. Leverage their expertise while actively participating in the development and refinement of actuarial methodologies and practices.
EDUCATION/EXPERIENCE REQUIRED:
- Bachelor's degree in a finance or quantitative discipline is required.
- Experience: Minimum of five (5) years of experience in Medicare Advantage and Drug plan bid filing or Commercial or Medicaid pricing and product development, utilizing actuarially sound methodologies. Demonstrated expertise in financial analysis and modeling, with a focus on Healthcare Analytics.
- Leadership: Proven track record of at least five (5) years of managerial experience, preferably leading and directing other leaders. Ability to inspire and motivate a diverse team, fostering a culture of continuous learning and professional growth.
- Technical Proficiency: Advanced proficiency in Excel, especially in model development. Strong analytical skills and attention to detail, with the ability to interpret complex data and communicate findings effectively.
CERTIFICATIONS/LICENSURESREQUIRED:
- Associate of the Society of Actuaries (ASA) required.
- Fellow of the Society of Actuaries (FSA) preferred.
Join our passionate and dedicated team at Health Alliance Plan and contribute to our mission of providing exceptional healthcare services to our members. We offer a competitive salary, comprehensive benefits package, and the opportunity to work in a collaborative and supportive environment.
