Chief Actuary

Job Summary:

The Chief Actuary will play a key role in providing reserving, forecasting, analytical and decision-making support across ArchWell Health's Operations, Clinical, and Finance teams. This will be a colleague who is motivated by the challenge of answering complex medical economics questions using a variety of data sources. This is a fast-paced position that will enable high-quality personal development and growth.

Duties/Responsibilities:

• Develop, iterate and maintain reserve/IBNR models for financial close and analysis
• Provide medical expense projections models for budgeting and forecasting
• Identify, monitor, and analyze principal health care cost drivers, by market segment and/or by provider, including utilization and referral patterns and reimbursement rates
• Research healthcare delivery topics, analyze data, present results, and recommend solutions to address business challenges by applying knowledge of medical claims analysis, critical-thinking skills, and healthcare experience/expertise
• Develop and implement strategy and success metrics for ArchWell Health's actuarial function in alignment with business objectives
• Provide ongoing leadership, development, and support for team members
• Analyze claims, membership, and prior authorization data to identify early signs of trends or other issues related to medical care costs and quality of care
• Provides actuarial support for by identifying trends and profitability drivers utilizing sound statistical methods.
• Utilizes experience with HCCs and RAFs to forecast revenue projections
• Structure analytical results in an organized, visual manner to tell a meaningful, actionable story
• Work with Engineering team to source data, determine its credibility and usability, create end-user reports, and apply varying analytical techniques to solve specific business problems
• Perform ad-hoc requests from key stakeholders
• Interpret contractual language with a clear understanding of business rules and reporting requirements
• Execute other duties and special projects as needed, focusing on knowledge and skills development

Required Skills/Abilities:

• You enjoy independent research and presenting solutions to complex problems
• You work both collaboratively and independently to complete complex analyses, leading to actionable strategic and financial business decisions
• You apply strong critical thinking skills to anticipate questions from key stakeholders and consider all aspects of an analysis before completion
• You exhibit initiative in exploring and discovering opportunities to improve company performance through data analysis
• You establish trusting, professional relationships with internal, senior stakeholders

Minimum Qualifications:

• Bachelor's degree in Applied Math, Statistics, Actuarial Science, Economics, or a related field required
• At least an Associate of the Society of Actuaries (ASA) required
• Minimum of 10 years of progressive experience in actuary role and least 5 years in a leadership position as an analyst with a health plan, ACO, RBE, or consulting firm
• Experience with Medicare Advantage Bids and CMS HCC Models
• Expertise in MS Excel, including proficiency using formulas, PivotTables, PowerBI, graphing and other reporting and presentation features
• Experience working with internal groups, including IT, to procure necessary datasets preferred
• Experience in data mining working with large data repositories and/or relational databases with SQL experience strongly preferred
• Experience creating product trend analyses using statistically valid methodologies
• Embodies and serves as a role model of ArchWell Health's Values:

• • Be compassionate
  • Strive for excellence
  • Earn trust
  • Show respect
  • Stay resilient
  • Always do the right thing

About ArchWell Health:

At ArchWell Health, we're creating a community of caring designed to help our members stay healthy and engaged. By focusing on a strong provider-patient relationship, routine wellness, and staying active, our members enjoy a higher level of care and better quality of life after the age of 60. Everything we do is for seniors. We believe seniors should be heard, listened to, and given ample time by their physicians to live well later in life.

Our value-based care model is designed to prevent illnesses while keeping members healthy and happy in every aspect of their life. We deliver best-in-class primary care at comfortable, accessible neighborhood centers where older adults can feel at home and become part of a vibrant, wellness-focused community. We're passionate about caring for older adults and united by the belief that caring has the power to change everything for our members.

ArchWell Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to their race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other protected classification.