The Senior Director and Actuary determines risk, makes pricing decisions and formulates employee benefits plans. This position will be responsible for support of our Medicare Advantage and MSSP Value Based Contract Analytics and Actuarial Analysis.
Develops pricing models using mathematical modeling techniques and statistical concepts to determine probability and assess risks.
Develops forecasts of expense and funding for employee plans.
Evaluates the effectiveness of financial management programs that seek to control and minimize risk.
Presents reports, explaining their implications to stakeholders, and advising on risk limitation.
Oversees contract model development to illustrate potential financial outcomes under value based program participation.
Provides insights to contracting team on contract terms that will allow for strong financial outcomes.
Subject Matter expert on Medicare Advantage plans and products and represents Ascension in discussions with health plans on potential joint venture agreements.
Subject Matter expert on Medicare ACO agreements and provide expert guidance and advice on appropriate levels of participation by Ministry Market.
Oversees and directs analysis on drivers of financial performance for Medicare Advantage and MSSP value based contract performance including risk adjustment and medical cost analysis.
Provides guidance on possible corrective actions to ensure high performance.
Certified Actuary Certification obtained prior to hire date or job transfer date.
Fellow of the Society of Actuaries (FSA) and Member of the Academy of Actuaries (MAAA)
Bachelor's Level Degree preferably in Math, Economics, Actuarial Science or equivalent degree.
At least ten years progressive experience of actuarial service lines including pension, savings, deferred compensation and health & welfare plans.
Demonstrated skill and experience in being able to understand applicable laws and regulations and apply them to practical situations.
5 years of experience in pricing and product development of Medicare Advantage plans preferred.
Preferred experience with Medicare ACOs.
Experience managing a small team of highly skilled professionals preferred.
Equal Employment Opportunity
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Website : http://www.ascension.org
Ascension Health is transforming healthcare by providing the highest quality care to all, with special attention to the poor and vulnerable. Ascension Health, which provided $1.3 billion in care of persons who are poor and community benefit last year, is the nation's largest Catholic and nonprofit health system. Our mission-focused Health Ministries employ more than 150,000 associates serving in more than 1,500 locations in 23 states and the District of Columbia. Our Strategic Direction incorporates an outward promise to those we serve to deliver Healthcare That Works, Healthcare That Is Safe, and Healthcare That Leaves No One Behind, for Life, by the year 2020. We continue to build on the remarkable progress we have made as a healing ministry and share a sacred obligation on behalf of those we serve.Our actions are guided by the Mission, Vision, and Values on which our ministry is built. Through the conviction of our local and national leaders, our strategic direction guides us to provide: