Senior ActuaryIt's rewarding to be on a team of people that truly believe in making an impact!We are committed to building the best primary care environment for patients and are seeking healthcare enthusiasts to join us.Job SummaryAs a Senior Actuary within the Finance Department, you will assist with complex actuarial and medical economics projects including trend calculations, reserving estimates, risk score calculations, risk assessments and savings analyses. You will build risk adjustment and medical economic models used to forecast revenue, cost and utilization trends that will be used in the company's short and long-range planning. You will work collaboratively with clinical and operations leaders to drive performance.Essential Duties & ResponsibilitiesPerform and support trend analysis of medical and pharmacy claims data for the Medicare and Medicaid lines of businessCollaborate with Operation teams on quantification and tracking of trend initiatives that will impact financial resultsCalculate RAF score projections utilizing benchmarks and historical operational improvement experience at region and/or markets for use in finance reporting and forecastingCollaborate with Operations and Coding teams on documentation initiatives that may impact RAF score projectionConduct complex actuarial analyses to assess risk scoresIdentify and implement appropriate analytic and forecasting methodologiesBuild financial/actuarial models to support budget and forecastingCompile, organize, categorize, and analyze large data sets using SQLAssist in leading complex analytic projects leveraging data from multiple sourcesAssist with the design and development of dashboards and key performance indicator reports to meet business needsAd-hoc modeling and projects.Supervisory ResponsibilitiesNo supervisory responsibilitiesEducation & ExperienceRequires a Bachelor's degree, preferably within Actuarial Science, Finance/Accounting, Mathematics, Statistics or a related field from an accredited college or university3-5 years of actuarial and/or statistics experienceExperience in the health insurance industry (Medicare)Associate, Society of Actuaries (ASA) preferredEducation RequirementsEducation LevelDisciplineRequiredBachelor DegreeActuarial Science, Finance/AccountingKnowledge, Skills & ProficienciesUnderstanding of CMS guidelines and specifications as it relates to Medicare Advantage and Risk Adjustment modelsExperience measuring impact and ROI of operational programs and services related to medical and pharmacy cost reduction initiativesFamiliarity with medical economics and actuarial forecastingExperience in predictive modeling, data manipulation, reporting, and analysisExperience synthesizing analysis into actionable and easy to digest insightsDemonstrated proficiency with SQLProficient with MS Excel, including creating Macros, Power Pivot Tables, SUMIFS, SUMPRODUCT, and VLOOKUPs, etc.Physical RequirementsThis position works under usual office conditions. The employee is required to work at a personal computer as well as be on the phone for extended periods of time.
Must be able to stand, sit, walk and occasionally climb. The incumbent must be able to work extended and flexible hours and weekends as needed. Physical demands include ability to lift up to 50 lbs. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.Work ConditionsMust be able to perform essential functions such as typing, standing, sitting, stopping, and occasionally climbing.Travel RequirementsAmount of Expected TravelDetailsNoTools & Equipment UsedComputer and peripherals, standard and customized software applications and tools, and usual office equipment.DisclaimerThe duties and responsibilities described above are designed to indicate the general nature and level of work performed by associates within this classification. It is not designed to contain, or be interpreted as a comprehensive inventory of all duties, responsibilities, and qualifications required of associates assigned to this job. This is not an all-inclusive job description; therefore, management has the right to assign or reassign schedules, duties, and responsibilities to this job at any time. Cano Health is an equal opportunity/affirmative action employer.
All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.Join our team that is making a difference!