[Hiring] Manager, Actuarial Services @Imagine Pediatrics

Role Description

As Manager, Actuarial Services you will combine your management capabilities and actuarial expertise to lead an actuarial team to conduct and present analytics on several business-critical initiatives. This position will be instrumental in supporting a value-based care business model for the pediatric Medicaid population. Key projects will include:

• Value-based care savings calculations
• Monthly close processes
• Development and application of IBNR estimates
• Reporting/presenting financial and clinical results drivers

Primary functions and responsibilities of this role will include but are not limited to:

• Manage and develop the processes and internal capabilities necessary to measure performance of value-based/shared savings arrangements and communicate valuable insights to key stakeholders.
• Manage monthly development and application of IBNR estimates.
• Partner with the Healthcare Economics (claims data analytics) team to demonstrate value our clients achieve with Imagine through the reporting of revenue/risk score trends, healthcare utilization trends, and financial savings.
• Analyze profitability by duration, acuity, and resource allocation to inform strategic recommendations to senior leadership.
• Work closely with other finance teams to monitor performance against forecasts, analyzing and explaining drivers of variances from revenue, cost, and membership.
• Prepare analyses for shared savings settlement discussions with payer partners.

Qualifications

• Associate or Fellow of the Society of Actuaries
• Bachelor’s degree
• Minimum of 5 years of health actuarial experience, experience with value-based reimbursement strategies and affordability initiatives preferred
• Minimum of 2 years of Medicaid managed care experience
• Experience negotiating Medicaid managed care capitation rates is strongly preferred
• Prior leadership experience is preferred but not required
• Ability and willingness to train and transfer knowledge to junior level staff
• Actuarial knowledge of best practices for evaluation, modeling (cost, risk score and revenue) and analytics
• Strong SQL skills
• Ability to work effectively in a dynamic and fast-paced environment
• Strong communicator (both written and verbal) with an ability to break down complex and technical concepts in an easy-to-understand way
• Strong organizational, documentation and problem-solving skills
• Strong business acumen and interpersonal skills

Benefits

The role offers a base salary range of $150,000 - $180,000 in addition to an annual bonus incentive, competitive company benefits package and eligibility to participate in an employee equity purchase program (as applicable). We provide these additional benefits and perks:

• Competitive medical, dental, and vision insurance
• Healthcare and Dependent Care FSA; Company-funded HSA
• 401(k) with 4% match, vested 100% from day one
• Employer-paid short and long-term disability
• Life insurance at 1x annual salary
• 20 days PTO + 10 Company Holidays & 2 Floating Holidays
• Paid new parent leave
• Additional benefits to be detailed in offer

Company Description

Imagine Pediatrics is a tech enabled, pediatrician led medical group reimagining care for children with special health care needs. We deliver 24/7 virtual first and in home medical, behavioral, and social care, working alongside families, providers, and health plans to break down barriers to quality care. We do not replace existing care teams; we enhance them, providing an extra layer of support with compassion, creativity, and an unwavering commitment to children with medical complexity.