“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 – Provider Risk (PR) will have the lead role in providing actuarial support to Bright Health’s provider risk bearing entities, including NeueHealth and owned clinics. 

YOUR RESPONSIBILITIES

• Support the Government Programs & Provider Risk Actuarial Models team’s development of actuarial models to be used for medical expense and trend analysis and forecasting, provider risk contract evaluation, and Direct Contract (DC) bid development
• Lead an inclusive (to be developed) quarterly medical expense analysis and forecasting process in coordination with various NeueHealth, owned clinics and Bright SMEs and leaders
• Lead responsibility for evaluating financial implications of provider participation in networks for DC opportunities
• Lead responsibility for provider risk contract evaluation work
• Lead responsibility for DC bid development, submissions and approvals
• Manage and mentor Consulting Actuaries and Analysts to achieve work deliverables and ensure their development relative to team growth goals
• Lead development of contract analysis assumptions to inform contract evaluation decisions and plan benefit development and provide guidance to the NeueHealth and owned clinics teams
• Support product and business strategy working with NeueHealth and owned clinics leadership

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 3 years working with CMMI programs (MSSP, NexGen ACO, Direct Contracting) and evaluating provider contracting risk arrangements 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

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 CMMI program evaluation and bid development
• Understanding of company practices related to management of member populations for purposes of estimating risk
• 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
• Ability to clearly and concisely present complex technical analyses and recommendations to C-Level leadership

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!