The Role
Manages actuarial services for provider relations, value-based contracting, forecasting, pricing, reserving, and risk assessment. Defines contract performance measures and benchmarks, validates statistical methodologies, supervises actuarial analysts, monitors insurance risk profiles, analyzes key drivers, and presents findings to senior financial leadership. Requires expertise in health insurance, managed care, commercial and government programs, Medicare pricing, medical economics, and risk adjustment.
Summary Generated by Built In
Company Highlights
- This top ranked Healthcare Company was awarded the #2 “Best Places to Work for Women & Diverse Manager” by Diversity MBA Magazine.
- U.S. News & World Report consistently ranks this company among the nation’s best hospitals in many specialties.
- This company provides generous merit increases, two-week parental leave, and true work-life balance
Benefits and Features
- Medical insurance, including prescription and vision coverage; Dental Insurance
- Flexible spending accounts
- Disability coverage plus basic life and accidental death and dismemberment (AD&D) insurance
- Supplemental life and AD&D insurance for employee
- Supplemental life insurance for employee's spouse and children
- Cash balance plan
- Savings plan
- Paid time off (PTO) and holiday pay
- Tuition assistance for employees, their spouses, and eligible dependents
- Adoption assistance
The Role You Will Play
- The Actuarial Manager, Value-Based Contracts ensures that the Actuarial Department provides excellent services to various internal and external clients in the areas of provider relations, contracting and forecasting.
- The Manager determines the performance measures, associated benchmarks, and other contractual components to include in new-formed value-based contracts as well as assures reliability of measures and statistical methodologies in tracking performance.
- In addition, this role will supervise actuarial analysts.
- This role is entrusted to work closely with Enterprise Risk Management and key internal stakeholders to build and enhance insurance (underwriting and reserving) risk assessment, monitor changes to the risk profile, risk analytics, and understand key drivers as well as present to senior financial leadership.
Community Highlights
- The position can work from a remote home office based within the United States.
- This company is headquartered in Pittsburgh, PA
Background Profile
- Expertise in actuarial value-based contracting, commercial pricing, Medicare pricing, reserving, medical economics, and Medicare or Medicaid risk adjustment.
- 6+ years of progressive Actuarial experience in health insurance, managed care, or related consulting business
- Familiarity with commercial and government health programs
- ASA or FSA required
- Bachelors’ degree in Mathematics, Actuarial Science, or related field
Skills Required
- 6+ years of progressive actuarial experience in health insurance, managed care, or related consulting
- ASA or FSA designation
- Bachelor's degree in Mathematics, Actuarial Science, or a related field
- Expertise in actuarial value-based contracting, commercial pricing, Medicare pricing, reserving, medical economics, and Medicare or Medicaid risk adjustment
- Familiarity with commercial and government health programs
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The Company
What We Do
Kalos Consulting, Inc. helps growth-oriented organizations build strong, sustainable teams through recruiting, on-demand talent solutions, leadership growth, executive coaching, and strategy consulting. Its Kalos Essentials framework supports repeatable hiring systems, leadership alignment, retention, and values-based performance. The firm also provides specialized talent and consulting services spanning financial analytics, risk management, software and technology, administrative operations, and sales and marketing functions.
