Data Analytics / Actuarial

Proselect Management Inc; Taguig; Hybrid; PHP 558,000 - 781,200; Full time

Benefits offered by this job

Health Insurance

Life Insurance

HMO

Retirement Plan

Job Training

Professional Development

Job summary

A leading healthcare consulting firm is seeking a Managed Care Value-Based Expert in Taguig. This hybrid role demands advanced analytical skills and expertise in healthcare finance, requiring applicants to have a Bachelor's degree and 3-7 years of relevant experience. The successful candidate will lead complex financial modeling, monitor performance evaluations, and support contract negotiations. The position also entails mentoring and contributing to financial forecasting and reporting, offering an outstanding opportunity for career development.

Qualifications

• Bachelor’s degree required in Economics, Actuarial Science, Health Economics, Business Administration, Finance, Accounting, or related field.
• 3–7+ years of experience in healthcare finance, payer analytics, or healthcare consulting.
• Advanced proficiency in SQL and Excel, experience with Tableau or Power BI.

Responsibilities

• Prepare advanced reimbursement and performance analyses for contract negotiations.
• Design and evaluate value-based payment models.
• Lead monthly forecasting and prepare financial reporting packages.
• Conduct quarterly reconciliation audits.

Skills

Financial analysis

Data analysis

Negotiation strategy

Healthcare finance

Education

Bachelor’s degree in relevant field

Tools

SQL

Excel

Tableau

Power BI

Job description

Hybrid - Taguig 3-5 Yrs Exp Bachelor Full-time

Job Description

Government Mandated Benefits

13th Month Pay

Insurance Health & Wellness

Health Insurance, Life Insurance, HMO

Company Equipment, Retirement Plan

Professional Development

Job Training, Professional Development

The Managed Care Value-Based Expert provides subject-matter expertise and advanced analytical support for managed care contracting and value-based payment arrangements. The role leads complex financial modeling, contract performance evaluation, reconciliation activities, and forecasting to support negotiation strategy, compliance, financial performance, and enterprise decision-making.

Essential Job Functions

• Prepare advanced reimbursement, financial impact, and performance analyses to support managed care contract negotiations and payer strategy
• Design and evaluate value-based payment models, including shared savings, quality metrics, risk corridors, and attribution methodologies.
• Develop pro forma, sensitivity, and stress-test analyses to assess financial implications of proposed contract changes and market trends.
• Monitor contract and value-based program performance; identify underpayments, compliance gaps, payment trends, and financial risks.
• Lead monthly forecasting and prepare financial reporting packages summarizing value-based performance and variance analysis.
• Conduct quarterly and annual reconciliation audits to ensure payer compliance with contractual terms.
• Develop tools and methodologies to monitor healthcare trends and improve value-based forecasting accuracy.
• Synthesize payer data, market intelligence, and industry developments to inform negotiation strategy and executive decision-making
• Create executive-level reporting and scalable analytic processes across programs
• Provide technical guidance and mentorship to Managed Care Analysts and contribute to process improvements.

Required

• Bachelor’s degree in Economics, Actuarial Science, Health Economics, Business Administration, Finance, Accounting, Healthcare Administration, or related field

Work Experience

• 3–7+ years of progressive experience in healthcare finance, payer analytics, medical economics, or healthcare consulting
• Experience supporting value-based contract development including performance measurement, quality metrics, reconciliation, and dispute resolution
• Experience in forecasting, audit, predictive analytics, and contract performance management
• Advanced proficiency in SQL and Excel; experience with Tableau and/or Power BI
• Experience analyzing large healthcare claims, reimbursement, and value-based datasets
• Strong ability to translate complex data into strategic insights for diverse stakeholders