NeueHealth
NeueHealth is a healthcare company focused on providing accessible, affordable, and high-quality care to all health consumers. Formerly known as Bright Health, it operates through two primary segments: NeueCare, which delivers comprehensive healthcare services via owned and affiliated clinics, and NeueSolutions, which supports independent providers in performance-based care arrangements. With a strong emphasis on understanding patient needs, NeueHealth aims to align the interests of health consumers, providers, and payors to enhance healthcare experiences and outcomes.
Value-based care • Primary care • patient engagement • Physician enablement • ACO REACH
Lead Actuarial Consultant - Risk Adjustment
February 18
NeueHealth
NeueHealth is a healthcare company focused on providing accessible, affordable, and high-quality care to all health consumers. Formerly known as Bright Health, it operates through two primary segments: NeueCare, which delivers comprehensive healthcare services via owned and affiliated clinics, and NeueSolutions, which supports independent providers in performance-based care arrangements. With a strong emphasis on understanding patient needs, NeueHealth aims to align the interests of health consumers, providers, and payors to enhance healthcare experiences and outcomes.
Value-based care • Primary care • patient engagement • Physician enablement • ACO REACH
📋 Description
• The Lead Actuarial Consultant will lead actuarial workflows in support of risk adjustment activities. • Support coding accuracy improvement workflows related to risk scores and forecasted revenue. • Additional cross-functional support to various departments that may need data analysis or modeling support.
🎯 Requirements
• 8+ years of actuarial experience with 5+ years working within healthcare. • 3+ years working with a CMS/HHS HCC risk adjustment modeling is required. • 2+ years working with a CMMI ACO Model (of any kind) is strongly preferred. • 2+ years working with individual/small group ACA rate filings or Medicare Advantage bids is preferred. • Working knowledge of the CMMI Direct Contracting or Accountable Care Organization (ACO) program(s). • Working knowledge of industry value-based contracts between payers and providers (risk sharing arrangements). • Experience leading projects and ownership of deliverables.
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