4 Licensed Behavioral Health Clinician - R010995 Jobs in Queens, NY
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Licensed Behavioral Health Clinician - R010995
$87k-106k (estimate)
Full Time
3 Days Ago
VNS Health is Hiring a Licensed Behavioral Health Clinician - R010995 Near Queens, NY
OverviewLeads the actuarial aspects of Medicare Advantage bid process, ensuring accuracy, compliance and strategic alignment with organizational goals.
Compensation:$137,800.00 - $183,800.00 Annual
What We Provide
Compensation:$137,800.00 - $183,800.00 Annual
What We Provide
- Referral bonus opportunities
- Generous paid time off (PTO), starting at 30 days of paid time off and 9 company holidays
- Health insurance plan for you and your loved ones, Medical, Dental, Vision, Life and Disability
- Employer-matched retirement saving funds
- Personal and financial wellness programs
- Pre-tax flexible spending accounts (FSAs) for healthcare and dependent care
- Generous tuition reimbursement for qualifying degrees
- Opportunities for professional growth and career advancement
- Internal mobility, generous tuition reimbursement, CEU credits, and advancement opportunities
- Leads the development and execution of the actuarial aspects of Medicare Advantage (MA) bids, including actuarial assumptions, modeling and forecasting.
- Collaborates with cross-functional teams to develop bid packages that align with business objectives and regulatory guidelines. Ensures accurate and compliant submissions and facilitate successful bid approvals.
- Communicates actuarial findings, assumptions, and recommendations to internal and external MA stakeholders.
- Analyzes and validates data relevant to bid submissions. Reconcile bid data with reported financials to ensure data integrity and accuracy.
- Establishes actuarial frameworks and optimize processes to efficiently interpret MA data, enabling timely and accurate decision-making.
- Provides data and analytical support to Risk Adjustment team, Care Management and other related teams to optimize revenue and manage medical expenses.
- Tracks financial performance of MA products and monitor emerging experience and trends.
- Collaborates closely with reserving actuaries to develop IBNR reserves for MA products.
- Provides guidance and assistance to Accounting department in establishing accruals related to MA.
- Collaborates with internal and external partners to identify MA growth opportunities.
- Identifies business needs and requirement for MA vendor partnerships. Track and evaluate vendor performance and alignment with growth goals.
- Conducts long term projection and ROI analysis for launching new products, expanding into new markets and optimizing existing portfolio.
- Serves as a subject matter expert on actuarial matters related to MA, offering mentorship and training to junior actuarial staff.
- Performs all duties inherent in a supervisory role. Ensures effective staff training, interviews candidates for
- employment, evaluates staff performance, and recommends hiring, promotions, salary actions, and
- terminations as appropriate.
- Participates in special projects and performs other duties as assigned.
- Associate of the Society of Actuaries (ASA) designation preferred
- Member of the American Academy of Actuaries (MAAA) preferred
- Bachelor's Degree in Mathematics, Actuarial Science, Statistics or equivalent work experience required
- Minimum five years of progressively responsible actuarial experience in a Health Plan/ Managed Care organization or similar environment required
- Minimum two years experience specially related to Medicare Advantage bidding required
- Knowledge of core health actuarial processes including Pricing, Valuation, and Budgeting/Forecasting preferred
- Efficiency in manipulating and analyzing large and complex data sets from multiple sources using SAS. Proficient in MS Excel spreadsheets and Visual Basic. Knowledge of Pytho preferred
- Ability to multi-task required
- Prior experience communicate quantitative analyses and results in a clear, precise and actionable manner preferred
Job Summary
JOB TYPE
Full Time
SALARY
$87k-106k (estimate)
POST DATE
07/04/2024
EXPIRATION DATE
08/09/2024
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