The Director, Actuary will play a key role in understanding the member populations served by firsthand and managing the financial risks associated with value-based care constructs. As the Company’s first actuary, you will build the initial frameworks, systems, and data models to create a best-in-class, value-based organization. While the Director, Actuary will bring technical expertise with a strong handling of large quantities of data, the role will similarly require working collaboratively with strategic and operational leaders across the organization to guide future program and service development in order to deliver the highest impact to individuals most in need of firsthand’s support and services.
This is a unique opportunity to spearhead the development of an actuarial department for an interdisciplinary service model serving individuals with serious mental illness. The Director, Actuary must be comfortable with a fast-based, unstructured environment and have a willingness to change direction as new information and insight becomes available. This role is a remote position and will report directly to the Senior Vice President of Finance.
As the company’s first Actuary, you will:
- Analyze large quantities of healthcare claims and data to assess patterns and risks across multiple indicators, including medical costs, utilization patterns by modality, and intra-year trends across comparable populations
- Develop financial projections and forecasts (including creating/utilizing medical claim expense reserve and incurred but not reported analyses) in addition to retrospective analyses, across multiple member groups supported
- Work closely with Business Development and Customer Success, including informing contract structures and terms, monitoring and projecting performance for existing and future risk-sharing arrangements, and estimating required capitation funding and prospective operations / risk targets
- Develop clear viewpoints on recommended or required courses of action informed by your analyses
- Work closely with leaders across the organization, including Finance/Accounting, Clinical, Operations, Strategy, Legal, and Data
- Serve as the bridge between the Company’s operational performance against contractual targets and internal goals and financial reconciliation
- Shape the future of firsthand’s Finance, Accounting, and Actuary teams by developing and implementing best-in-class systems and processes
- Stay up-to-date with changes in laws, regulations, and industry standards that impact our organization in addition to assessing and providing recommendations in how to mitigate risks and leverage opportunities
You will be a good fit if you have a:
- Fun time with large amounts of data (often unstructured), including healthcare claims, financial statements, and publicly available sources of demographic and healthcare data
- Self-starting and intellectually curious mindset in order to break down challenging, complex problems into questions that can be explored and answered
- Ability to work collaboratively with all levels of employees, management, and outside parties (including consultants, advisors, and customers)
- Ability to summarize and visualize claims, statistical, and financial data into meaningful insights for the relevant audience (e.g., management, market leaders)
- Willingness to try on new hats and seek new knowledge in areas adjacent to your actuarial expertise – we are a small, fast-paced team!
Bonus points if you:
- Have 3+ years experience at a managed care organization or risk-based healthcare service provider
- Are based in Eastern or Central timezones
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