The Actuarial Consultant will be responsible for:
- Conduct analysis to identify all drivers of medical expense trends on a PMPM, utilization, and unit cost basis for assigned market
- Provide analytical support as needed for provider contract negotiations, including risk and value-based arrangements
- Work directly with assigned market MCM leader and market leadership team to provide the data analysis necessary to support their local MCM initiatives agenda and performance against budget/forecast
- Work directly with the national Director of MCM and VP of Field Finance to ensure the program for the identification of all MCM opportunities is maximized and works efficiently for stakeholders
- Work directly with pricing team to ensure all requisite MCM initiatives are appropriately analyzed and valued for inclusion in all pricing activities
The Actuarial Consultant should have the following qualifications:
- Bachelor's degree required in Math, Statistics, Economics, Actuarial Science, or a related field
- 3-4 years of actuarial experience with 2+ years working within health care
- 2+ years working with individual ACA rate filings if preferred, but small group ACA experience would suffice
- ASA or 4+ exams passed