Actuarial Manager - Payer Analytics

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Astrana Health

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Description

• We are seeking an Actuarial Manager who thrives on independent thinking and enjoys building models and analyses from the ground up. • This role offers the opportunity to leverage your healthcare and actuarial expertise to contribute to our leading position in the value-based care revolution. • Reporting to the Senior Director, Actuary, this position is open for remote work. • Craft sophisticated deal models to support contract negotiations with health plans, ensuring favorable terms and optimal outcomes. • Utilize data analytics to provide consultative support, driving financial and operational performance improvements for our health plan contracts. • Employ advanced data tools to track, analyze, forecast, and report on the financial impact of payor contracts. • Identify, develop, and document audit findings, presenting results to key stakeholders to inform strategic decisions. • Build robust analytical infrastructure, including comprehensive reports and dashboards, to monitor payor financial performance. • Stay ahead of industry trends impacting contracting, such as payor market share, STAR rating changes, bid strategies, and reimbursement trends. • Conduct a variety of analyses related to benchmarking, contract optimization, investor relations, risk adjustment, and more. • Work closely with teams across ACO, Analytics, Data, Finance, M&A, Contracting, Medical Economics, and Operations. • Analyze healthcare utilization patterns and cost trends to identify areas for improvement and opportunities for cost savings.

Requirements

• ASA and FSA credentials or near attainment of FSA credentials. • 5+ years of experience in actuarial roles. • 2+ years of experience in VBC or VBC adjacent roles. • Advanced knowledge of Microsoft Excel. • Intermediate knowledge of SQL. • Understanding of the actuarial continuum (both pricing/forecasting and valuation/reserving). • Proficiency and desire to build actuarial models from scratch. • Comfortable working on a small team in a fast-paced environment. • Knowledge in health plan reimbursement methodologies. • Experience working on the provider side of healthcare. • Risk adjustment experience. • Knowledge working with PowerBI. • Experience in the California healthcare market. • Champion of independent critical thinking; unafraid to challenge the status quo and explore innovative solutions.