ProvidencePR

Manager Actuarial Analytics, Medicare / Medicaid *Remote*

Providence
United States only
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Providence Health Plan caregivers are not simply valued – they’re invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Providence Health Plan is calling a Manager Actuarial Analytics who will:

  • Lead the review of Medicaid capitation rate assumptions and methodology
  • Provide oversight to financial/encounter data submission in support of Medicaid capitation rate setting
  • Provide expertise and consultation to support the Medicare bid process and pricing strategy
  • Evaluate the financial performance for Medicaid/Medicare lines of business
  • Maintain an understanding of the changing health care trends and actuarial regulations and how they impact the organization
  • Remain current on government regulation and guidance as well as analytic techniques and methodologies, data sources
  • Build and maintain relationships with other leaders across the organization including Product, Finance, Regulatory, Pharmacy, and outside the organization (CMS, provider groups)
  • Coach and set priorities for direct reports

Providence is welcoming 100% remote work from anywhere within the United States with the exception of the below listed states:

  • Colorado
  • Hawaii
  • Massachusetts
  • New York
  • Ohio
  • Pennsylvania

Required qualifications for this position include:

  • Bachelor's Degree in Statistics, Computer Science, Mathematics, Social Science or another related field of study
  • 5+ years of healthcare actuarial experience; Experience working with Medicare Advantage pricing and bid development
  • Experience with writing queries in SQL or another programming language
  • Demonstrated experience applying project management skills in data-related and financial analysis projects

Preferred qualifications for this position include:

  • Master's Degree in Statistics, Computer Science, Mathematics, Social Science or another related field of study
  • Fellow or Associate in the Society of Actuaries (FSA or ASA)
  • Experience certifying the Medicare Advantage Bid
  • Experience with Commercial, Medicare, and Medicaid revenue methodologies
  • Demonstrated experience with managing professional staff who work independently on tasks and projects

Why Join Providence?

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.

At Providence, our strength lies in Our Promise of “Know me, care for me, ease my way.” Working at our family of organizations means that regardless of your role, we’ll walk alongside you in your career, supporting you so you can support others. We provide best-in-class benefits and we foster an inclusive workplace where diversity is valued, and everyone is essential, heard and respected. Together, our 120,000 caregivers (all employees) serve in over 50 hospitals, over 1,000 clinics and a full range of health and social services across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. As a comprehensive health care organization, we are serving more people, advancing best practices and continuing our more than 100-year tradition of serving the poor and vulnerable.

The amounts listed are the base pay range; additional compensation may be available for this role, such as shift differentials, standby/on-call, overtime, premiums, extra shift incentives, or bonus opportunities.

Check out our benefits page for more information about our Benefits and Rewards.

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About the job

Apply before

Jul 16, 2024

Posted on

May 17, 2024

Job type

Full Time

Experience level

Mid-level

Location requirements

Hiring timezones

United States +/- 0 hours
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