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Kalos Consulting, Inc.

Actuarial Manager Value-Based Contracts

Posted 23 Days Ago
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Remote
Hiring Remotely in US
Senior level
Remote
Hiring Remotely in US
Senior level
The Actuarial Manager leads actuarial services for provider relations, value-based contracting, forecasting, and risk assessment. Responsibilities include designing contract performance measures and benchmarks, validating statistical methodologies, supervising actuarial analysts, monitoring underwriting and reserving risk, analyzing risk drivers, and presenting findings to senior financial leadership. The role requires expertise in health insurance actuarial work, commercial and government healthcare programs, pricing, reserving, medical economics, and risk adjustment.
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Company Highlights

  • This top ranked Healthcare Company was awarded the #2 “Best Places to Work for Women & Diverse Manager” by Diversity MBA Magazine.
  • U.S. News & World Report consistently ranks this company among the nation’s best hospitals in many specialties.
  • This company provides generous merit increases, two-week parental leave, and true work-life balance

Benefits and Features

  • Medical insurance, including prescription and vision coverage; Dental Insurance
  • Flexible spending accounts
  • Disability coverage plus basic life and accidental death and dismemberment (AD&D) insurance
  • Supplemental life and AD&D insurance for employee
  • Supplemental life insurance for employee's spouse and children
  • Cash balance plan
  • Savings plan
  • Paid time off (PTO) and holiday pay
  • Tuition assistance for employees, their spouses, and eligible dependents
  • Adoption assistance

The Role You Will Play

  • The Actuarial Manager, Value-Based Contracts ensures that the Actuarial Department provides excellent services to various internal and external clients in the areas of provider relations, contracting and forecasting.
  • The Manager determines the performance measures, associated benchmarks, and other contractual components to include in new-formed value-based contracts as well as assures reliability of measures and statistical methodologies in tracking performance.
  • In addition, this role will supervise actuarial analysts. 
  • This role is entrusted to work closely with Enterprise Risk Management and key internal stakeholders to build and enhance insurance (underwriting and reserving) risk assessment, monitor changes to the risk profile, risk analytics, and understand key drivers as well as present to senior financial leadership.

Community Highlights

  • The position can work from a remote home office based within the United States.
  • This company is headquartered in Pittsburgh, PA

Background Profile

  • Expertise in actuarial value-based contracting, commercial pricing, Medicare pricing, reserving, medical economics, and Medicare or Medicaid risk adjustment.
  • 6+ years of progressive Actuarial experience in health insurance, managed care, or related consulting business
  • Familiarity with commercial and government health programs
  • ASA or FSA required
  • Bachelors’ degree in Mathematics, Actuarial Science, or related field

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