Director of Actuarial Provider Network Analytics & Pricing

Transformcap; Colorado; Hybrid; USD 156,000 - 235,000; Full time

Job summary

Judi Health in New York, Denver and Charlotte seeks a Director to lead Actuarial Provider Network Analysis and Pricing within the Judi Care Actuarial and Underwriting team. You will drive analytics, pricing, and contract analysis to inform negotiations and network strategy.

You will work with senior leaders across network, sales and underwriting, building out a team focused on pricing models, provider contracting, and total cost of care optimization.

Qualifications

• Bachelor's degree in mathematics or related field and SOA credentials.
• Minimum eight years actuarial experience in related field.
• Experience in provider contracting, network strategy, and pricing.

Responsibilities

• Lead and own provider network analytics infrastructure for total cost of care.
• Support negotiation strategy with modeling and analyses for contracts.
• Price and analyze provider tiering, episodes, and network innovations.
• Develop network strategy tools with contracting and delivery teams.
• Translate actuarial concepts into actionable business recommendations.
• Guide framework and assumptions for actuarial models.
• Model and price innovative benefit plan design leveraging network strategy.

Skills

Actuarial analysis

Leadership

Negotiation support

Education

Bachelor's degree in mathematics or related field

Associate of the Society of Actuaries

Fellow of the Society of Actuaries

Tools

SQL

SAS

Python

R

Job description

Judi Health in New York, Denver and Charlotte seeks a Director to lead Actuarial Provider Network Analysis and Pricing within the Judi Care Actuarial and Underwriting team. You will drive analytics, pricing, and contract analysis to inform negotiations and network strategy.

You will work with senior leaders across network, sales and underwriting, building out a team focused on pricing models, provider contracting, and total cost of care optimization.