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Our Primary Care Actuarial Team offers candidates the opportunity to support the evolution of value-based care across all lines of business by collaborating directly with primary care providers.
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Actuarial experience within value-based contracting across payers (Medicare Advantage, Commercial, Medicaid)- Strongly Preferred. Actuarial experience with CMS Initiatives such as MSSP, ACO Reach, Primary Care First- Strongly Preferred.
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Bachelor's degree, preferably with a quantitative major (e.g. actuarial science, statistics, mathematics, economics, data science) - Required. This role supports Evolent Primary Care activities as well as broader Actuarial business efforts.
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The Director, Actuarial utilizes and develops analytical tools to solve complex business challenges as well as support decision making that can have a considerable impact on the organization and patient health.
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5+ years of experience in a health actuarial setting- Required. Lead quarterly compliance testing and accounting recommendations for dedicated Value Based Care (VBC) contracts. Proficiency with query languages such as Python, R, SQL, or SAS, mechanics, implementation, and impact modeling- Preferred.
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Lead forecasting and modeling for value-based care arrangements with government and commercial payors, including medical expenses, risk scores, benchmark/premiums, attribution, and (Incurred but not reported) IBNR reserves.
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As a Director, Data Scientist for Finance and Actuarial, you will partner with Machine Learning Engineers, Data Engineers, Data Analysts and other specialists to transform financial and actuarial processes by building state-of-the-art actuarial, financial, and behavioral models.
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Scope of duties will include but not be limited to medical and pharmacy expense analyses, pre-sales analytics, underwriting, actuarial forecasting, and population health management analyses. The Analyst, Actuarial, will work closely with Wellvana’s actuarial, finance and analytics team in the development of value-based care insights supporting our vision, strategic direction, and performance.
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The Actuarial Sales Practice Leader strategizes with the IAS Leader, National Sales Director, and CG COO and CEO to develop and implement a comprehensive sales and growth plan for DB services, working closely with the other DB Practice Leaders (including Benefit Administration) and other senior managers as appropriate.
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Aid other actuarial departments with projects as needed. Proficient in SQL, Excel, VBA, R, Python, or similar. Experience with model development including data visualization tools such as Tableau, R Shiny, or Microsoft BI.
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Experience with BI tools (e.g. Power BI, Tableau, MicroStrategy)- Preferred. Experience in claims-based healthcare analytics to drive decision making and with Hierarchical Condition Category Risk Adjustment- Preferred.
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PreviousAccountable Care Organization (ACO) Experience - Strongly Preferred. We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router.
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Exceptionally strong analytical abilities, with track record of identifying insights from quantitative and qualitative data- Required. Partner with finance/accounting teams for revenue and expense recognition.
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Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.
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The expected base salary/wage range for this position is $135,000 up to $150,000. That's one reason why diversity and inclusion are core to our business. Associate or Fellow of the Society of Actuaries - Required.
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Title: actuarial Company: Levelset
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