“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.

ABOUT THE ROLE

The Director, Actuarial Services – Model Team (MT) will have the lead role in actuarial model building and maintenance in support of Government Programs (Medicare and Medicaid) Lines of Business and Provider Risk support (GPPR).

YOUR RESPONSIBILITIES

• Lead the design, building and maintenance of a medical expense and trend analysis and forecasting model in collaboration with, and for use by, other GPPR teams
• Lead the design, building and maintenance of a Medicare Advantage Bid (BPT) Development model in collaboration with, and for use by, the Medicare Advantage Actuarial team
• Lead the design, building and maintenance of a Medicare Advantage pricing model in collaboration with, and for use by, the Medicare Advantage Actuarial team
• Lead the design, building and maintenance of a provider risk contract evaluation model in collaboration with, and for use by, the Provider Risk Actuarial team
• Lead the design, building and maintenance of a Direct Contracting evaluation model in collaboration with, and for use by, the Provider Risk Actuarial team
• Lead the design, building and maintenance of a Direct Contracting Bid model in collaboration with, and for use by, the Provider Risk Actuarial team
• Lead the design, building and maintenance of a Medicaid rate evaluation model in collaboration with, and for use by, the Medicaid Actuarial team
• Manage and mentor Consulting Actuaries and Analysts to achieve work deliverables and ensure their development relative to team growth goals
• Provide support for other GPPR teams during their peak periods

SUPERVISORY RESPONSIBILITIES

• This position will have supervisory responsibilities including Consulting Actuaries and Analysts

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

• A Bachelor’s degree in Math, Statistics, Economics, Actuarial Science, or a related field is required
• Ten (10) or more years of experience working as a health care actuary, with a minimum of 5 years with Medicare Advantage products is required
• Associate or Fellow of the Society of Actuaries
• Meets or exceeds continuing educations requirements for SOA and the American Academy of Actuaries
• Understanding of healthcare claims data and model building

PROFESSIONAL COMPETENCIES

• Proficient in Microsoft Excel and other Office products
• Experience with forecasting, modeling, and SQL or SAS
• Expert level knowledge of healthcare pricing and bid development for Medicare Advantage products
• Produce, understand, and interpret internal and external analyses and reports; provide effective technical and non-technical support to internal and external stakeholders
• Strong communication and collaboration skills
• Strong management and leadership skills

LICENSURES AND CERTIFICATIONS

• Associate or Fellow of the Society of Actuaries 

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!