Director Actuarial Services

Evolent Health
US - Rhode Island - Providence
June 30, 2024

Evolent Health

Director, Actuarial Services

in

Providence ,

Rhode Island

Your Future Evolves Here
Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.
Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business.
Join Evolent for the mission. Stay for the culture.
What You'll Be Doing:
Our Primary Care Actuarial Team offers candidates the opportunity to support the evolution of value-based care across all lines of business by collaborating directly with primary care providers. We are advocates for creating patient value and demonstrate this by ensuring that our financial arrangements are actuarially sound and sustainable. We value humility, adaptability, intellectual curiosity, and accountability as we solve complex business problems.
The Director, Actuarial utilizes and develops analytical tools to solve complex business challenges as well as support decision making that can have a considerable impact on the organization and patient health. This role supports Evolent Primary Care activities as well as broader Actuarial business efforts.
What You Will Be Doing:
Lead forecasting and modeling for value-based care arrangements with government and commercial payors, including medical expenses, risk scores, benchmark/premiums, attribution, and (Incurred but not reported) IBNR reserves.
Partner with Evolent Care Partners (ECP's) Growth team to evaluate new payors and providers; Support negotiation of value-based contracts with payors, providers, and vendors
Lead quarterly compliance testing and accounting recommendations for dedicated Value Based Care (VBC) contracts.
Partner with team members on complex and ill-defined business problems
Creatively leverage public and non-public datasets to inform key analyses
Partner with finance/accounting teams for revenue and expense recognition
Consistently deliver high-quality, error-free deliverables
Manage a project queue; ensure projects meet strategic objectives and are managed to timelines
Be reliable; set clear expectations, communicate proactively, and escalate risks as needed
Qualifications - Required and Preferred:
Bachelor's degree, preferably with a quantitative major (e.g. actuarial science, statistics, mathematics, economics, data science) -

Required.
Associate or Fellow of the Society of Actuaries -

Required
• 5+ years of experience in a health actuarial setting-

Required
• Strong proficiency with Microsoft Excel-

Required.
Ability to communicate clearly with diverse stakeholders to solve problems; ability to translate between business needs and analytical needs -

Required.
Exceptionally strong analytical abilities, with track record of identifying insights from quantitative and qualitative data-

Required
• PreviousAccountable Care Organization (ACO) Experience -

Strongly

Preferred.
Actuarial experience with CMS Initiatives such as MSSP, ACO Reach, Primary Care First-

Strongly

Preferred.
Actuarial experience within value-based contracting across payers (Medicare Advantage, Commercial, Medicaid)-

Strongly

Preferred.
Experience in claims-based healthcare analytics to drive decision making and with Hierarchical Condition Category Risk Adjustment-

Preferred
• Leadership/ mentoring experience supporting team goals-

Preferred.
Proficiency with query languages such as Python, R, SQL, or SAS, mechanics, implementation, and impact modeling-

Preferred.
Experience with BI tools (e.g. Power BI, Tableau, MicroStrategy)-

Preferred.
Technical Requirements:
We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.
Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.

If you need reasonable accommodation to access the information provided on this website, please contact

***

for further assistance.
The expected base salary/wage range for this position is $135,000 up to $150,000. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts.
Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit!
For more insights about Evolent Health, click on Life At Evolent (***/) to learn more!
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Read the full job description and apply online on the recuiter's web-site

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