Actuarial Analytics Manager

Phenom Consulting; Portland (OR); Remote; USD 100,000 - 140,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

Retirement plan

Career development

Job summary

A leading healthcare consulting firm in the United States is seeking an Actuarial Analytics Manager to oversee Medicaid and Medicare programs. In this role, you will lead the analysis of capitation rates, manage financial submissions, and provide expertise for Medicare bids. The ideal candidate will have a Bachelor's degree in a related field and at least 5 years of healthcare actuarial experience. This position offers full remote flexibility and a comprehensive benefits package.

Qualifications

• Minimum of 5 years in healthcare actuarial roles.
• Experience in Medicare Advantage pricing and bid development.
• Ability to coach and manage teams.

Responsibilities

• Oversee the analysis of capitation rate assumptions for Medicaid.
• Manage submission processes for financial data.
• Provide specialized knowledge for Medicare bid processes.
• Evaluate financial performance for Medicaid and Medicare lines.

Skills

Healthcare actuarial experience

SQL proficiency

Project management skills

Strong analytical skills

Education

Bachelor’s Degree in Statistics, Computer Science, Mathematics, or related field

Job description

About the job Actuarial Analytics Manager

Calling Actuarial Leaders!

Phenom Consulting has partnered with a leading healthcare organization to grow their Actuarial team. We are seeking an Actuarial Analytics Manager with experience in the healthcare industry.

As Actuarial Manager, you will oversee and guide the organization’s Medicaid and Medicare programs. This role involves leading the review of capitation rate assumptions and methodologies, overseeing financial and encounter data submissions, providing expert consultation for Medicare bid processes, and evaluating financial performance. The ideal candidate will also maintain an understanding of evolving healthcare trends and regulations, and foster strong relationships with internal and external stakeholders.

What You’ll Do:

• Oversee Capitation Rates: Lead the analysis and review of capitation rate assumptions and methodologies for Medicaid.
• Data Submission Oversight: Manage the submission process for financial and encounter data to support Medicaid capitation rate setting.
• Medicare Expertise: Provide specialized knowledge and consultation to support Medicare bid processes and pricing strategies.
• Financial Performance Evaluation: Assess the financial outcomes for Medicaid and Medicare lines of business.
• Stay Informed: Keep abreast of changing healthcare trends, actuarial regulations, government regulations, guidance, analytic techniques, and data sources.
• Relationship Building: Develop and maintain strong relationships with leadership across various departments including Product, Finance, Regulatory, Pharmacy, as well as with external entities like CMS and provider groups.
• Team Leadership: Coach direct reports and set priorities for their tasks and projects.

What to Bring:

• Educational Background: Bachelor’s Degree in Statistics, Computer Science, Mathematics, Social Science, or a related field.
• Experience: Minimum of 5 years in healthcare actuarial roles with experience in Medicare Advantage pricing and bid development.
• Technical Skills: Proficiency in writing queries in SQL or other programming languages.
• Project Management: Proven ability to apply project management skills in data-related and financial analysis projects.

Preferred Qualifications

• Advanced Education: Master’s Degree in Statistics, Computer Science, Mathematics, Social Science, or a related field.
• Professional Certification: Fellow or Associate in the Society of Actuaries (FSA or ASA).
• Medicare Advantage Certification: Experience certifying Medicare Advantage Bids.
• Revenue Methodologies: Familiarity with Commercial, Medicare, and Medicaid revenue methodologies.
• Leadership Experience: Demonstrated ability to manage professional staff who independently handle tasks and projects.

What You’ll Get:

• Ability to work remote (must reside in California, Oregon, or Washington)
• Full suite of excellent benefits: medical, dental, well-being, retirement, and career development
• Play a key leadership role in a dynamic organization
• Industry leading salary and total compensation

If you’re an Actuarial Leader ready to take on a dynamic role with a leading organization, apply today for immediate consideration.