“Making Healthcare Right. Together.” is the cornerstone of all we do. Our vision is through powerful relationships with Care Partners, we help all people live healthy and brighter lives. To successfully achieve our mission and vision as we operate in a dynamic health care environment, we expect Bright employees to embody and uphold our core values in work and interactions, both internal and external: be brave, be brilliant, be accountable, be inclusive, and be collaborative.

The Actuarial Analyst II will work directly with the state market lead, state market MCM lead, the actuarial economics team, clinical leads, network leads and MCM initiatives team to identify all areas of emerging opportunity to reduce or improve unit cost positions and utilization outliers in support of all budget and pricing goals. Products overseen include IFP, Medicare Advantage, Small/Large Group, and any other future product started in an assigned market(s). This role will also interface with the lead pricing actuaries to ensure pricing actions and Actual-to-Priced-For reporting is current on all initiatives in process at a market and state level.

ROLE RESPONSIBILITIES

• Conduct all necessary analysis to identify all drivers of medical expense trends on a PMPM, utilization, and unit cost basis for assigned market(s), including regional differences, providers involved, and any other material view necessary to explain actual and emerging claim experience
• Integrate all “early warning” data available in the organization into analysis approach to ensure emerging trends are identified and addressed as they occur
• Provide analytical support as needed for provider contract negotiations, including risk and value-based arrangements
• Work directly with assigned market MCM leader and market leadership team to provide the data analysis necessary to support their local MCM initiatives agenda and performance against budget/forecast
• Work directly with the national Director of MCM and VP of Field Finance to ensure the program for the identification of all MCM opportunities is maximized and works efficiently for all stakeholders
• Provide analytical support and interface with market and national clinical leadership to ensure all utilization trends and possible solutions are identified
• Perform ad-hoc data analysis as needed to support market and state objectives
• Support the Actuarial team on all project work related to complex trends while also interfacing with internal and external stakeholders
• Work directly with pricing team to ensure all requisite MCM initiatives are appropriately analyzed and valued for inclusion in all pricing activities

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

• Bachelor’s degree required in Math, Statistics, Economics, Actuarial Science, or a related field
• 2-4 years of actuarial experience with 2+ years working within healthcare
• 2+ years working with individual ACA rate filings if preferred, but small group ACA experience would suffice
• Experience leading projects and taking ownership of deliverables is preferred
• Advancing towards ASA credentials

PROFESSIONAL COMPETENCIES

• Proficient in Microsoft Excel and other Office products
• Experience with SQL and/or SAS
• Working knowledge of healthcare pricing process for commercial products
• Understanding of company practices related to management of member populations for purposes of estimating risk
• Produce, understand, and interpret internal and external analysis and reports; provide effective technical and non-technical support to internal and external stakeholders
• Must be a self-starter and be able to work both as part of a team and individually 

LICENSURES AND CERTIFICATIONS

• Associate of the Society of Actuaries is preferred, but not required

ABOUT US

At Bright Health, we brought together the brightest minds from the health care industry and consumer technology, and together we created Bright Health: a new, brighter approach to healthcare, built for individuals. Our plans are easy to manage, personalized, and more affordable, giving people the quality care they deserve. Through our exclusive care partnerships with leading health systems in local communities, we are reshaping how people and physicians achieve better health together.

We’re Making Healthcare Right. Together. 

We've won some fun awards like Modern Healthcare and Forbes, etc. But more than anything, we're a group of people who are really dedicated to our mission in healthcare. Come join our team!

As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.

BRIGHT ON!