Actuarial Consultant at AdventHealth

Date Posted: 10/17/2020

Job Snapshot

  • Job Schedule
    Full-Time
  • Location:
    Maitland, FL
  • Date Posted:
    10/17/2020
  • Job ID:
    20016763
  • Job Family
    Accounting/Finance
  • Travel
    Yes, 25 % of the Time
  • Shift
    1 - Day

Job Description


Description

Actuarial Consultant

 
AdventHealth Corporate
 

Top Reasons to Work at AdventHealth Corporate

  • Great benefits
  • Immediate Health Insurance Coverage
  • Career growth and advancement potential
Work Hours/Shift:
  • Full-Time, Monday – Friday

You Will Be Responsible For:

  • Assesses risk of new Medicare Advantage, Full Risk, and Value-Based contracts
  • Develops underwriting policies
  • Assists with setting targets in the payor contracting process
  • Calculates trends and projections for Medicare Advantage, Full Risk, and Value-Based contracts
  • Develops and/or evaluates predictive models that will determine members with rising risk that would be candidates for care management intervention
  • Develops models and health outcomes ROI analyses to evaluate cost improvement, quality improvement, and care management projects and programs
  • Develop and improve IBNR models on an ongoing basis
  • Builds strong relationships with leadership, customers, and peers. Communicates appropriately and effectively with stakeholders, customers and supervisors, maintaining awareness of any issues, potential delays, and any situation of concern that may affect the productivity of supported programs, processes and systems
  • Work collaboratively to prioritize work to meet contractual goals
  • Perform other duties as assigned to ensure smooth and efficient operations of the organization.


Qualifications
What You Will Need:
  • Bachelors Degree in Actuarial Science, Mathematics, Statistics, Economics, Finance, or related field
  • Minimum 5 years of actuarial related experience in a health plan, healthcare consulting, or population health organization
  • ASA (Associate of the Society of Actuaries) Designation, or equivalent
  • Experience with Medicare products, including Medicare Advantage and the Medicare Shared Savings Program
  • Experience with state Medicaid programs
  • Experience with Individual and Group Exchange Benefit Plans
  • Experience with Risk Adjustment programs
  • Knowledge of the financial structure and processes of Value Based Payment and ACO models
  • Excellent analytical, problem solving, prioritization and operational skills
  • Excellent verbal and written communication skills
  • High-level interpersonal skills.  Able to work collaboratively and tactfully with multi-disciplinary and diverse teams that may include senior executives, employees, and customers
  • Effective computer skills, particularly Microsoft Office Outlook, Word, Power Point and Excel
  • Work independently to complete assigned tasks
 
Job Summary:

The Actuarial Consultant is part of a team that will assist the Population Health Services Organization in the transition from traditional risk models to Value-Based Care models and other innovative solutions to the healthcare risk challenges of today.  These types of challenges require an Actuarial Consultant who is not only technically strong but also innovative and can adapt quickly to the changes in the industry.

The Actuarial Consultant is responsible for assisting leadership in providing strategic and technical services related to risk assessment, underwriting, projections, predictive modeling, and health outcomes analysis.  The Actuarial Consultant will assess risk of new and existing contracts and make recommendations as how to mitigate that risk as well as to develop underwriting policies.  The Actuarial Consultant is responsible for developing predictive models that will assist with member intervention and be able to evaluate the value of those models and programs.

The Actuarial Consultant will be experienced with Medicare products, including Medicare Advantage and the Medicare Shared Savings Program.  Also, the Actuarial Consultant will have a good knowledge of Value-Based financial models.



This facility is an equal opportunity employer and complies with federal, state and local anti-discrimination laws, regulations and ordinances.

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