Actuarial Analyst, Provider Risk

Actuarial Analyst, Provider Risk

SCOPE OF ROLE

The Actuarial Analyst, Provider Risk will provide technical support to the Provider Risk Actuarial team on project work, modeling, and ACO REACH performance evaluation.  Additional cross-functional support role working with Line of Business, Analytics, Finance, Marketing and other areas of the company that may need data summarization, modeling framework or research help.

ROLE RESPONSIBILITIES

The Actuarial Analyst job description is intended to highlight major responsibilities within the role, but it is not limited to these items:

  • Support the Government Programs & Provider Risk Actuarial Models team’s development of actuarial models to be used for medical expense and trend analysis and forecasting, provider risk contract evaluation, and ACO REACH performance evaluation
  • Perform first pass (to be developed) quarterly medical expense analysis and forecasting process for review and modification by senior Provider Risk actuaries
  • Document and draft summary review memos in support of the (to be developed) quarterly medical expense analysis and forecasting process in coordination with senior Provider Risk actuaries in preparation for, and as follow up to, collaboration with various NeueHealth, owned clinics and Bright SMEs and leaders
  • Support the evaluation of financial implications of provider participation in networks for ACO REACH opportunities
  • Support provider risk contract evaluations and ACO REACH performance evaluations, interfacing with internal Bright team and external consulting actuaries.
  • Support Finance team in the development of forecasting models, projections and relevant information to inform C-Level business decisions
  • Support the development of contract analysis assumptions to inform contract evaluation decisions and plan benefit development and provide guidance to the NeueHealth and owned clinics teams
  • Perform ad-hoc data analysis using Excel and SQL
  • Other duties and responsibilities as assigned

EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE

  • Bachelor’s degree in Math, Statistics, Economics, Actuarial Science, or a related field required
  • Experience working with health care data and/or provider contract modeling work is preferred

PROFESSIONAL COMPETENCIES

  • Proficient in Microsoft Excel and other Office products
  • Experience with forecasting, modeling, SQL and SAS is preferred
  • Working knowledge of the healthcare industry
  • Produce, understand, and interpret internal and external analysis and reports; provide effective technical and non-technical support to internal and external stakeholders

LICENSURES AND CERTIFICATIONS

  • Minimum of two actuarial exams passed.
  • Actively pursuing the Associate of the Society of Actuaries (ASA) designation.

WORK ENVIRONMENT

The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer. Some travel may be required.  This position may be performed remotely.

 

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