Primary Duties:
- Provide visionary leadership for and management of the actuary team, including forming close partnerships with the six main teams (Strategy Payer Partners, Finance, Performance, Policy, Aledade+, and the other parts of Analytics) to support other duties.
- Lead Aledade’s Forecasting efforts, including working with Finance, Performance, Policy and other Analytics teams. Actuary team will lead the “future years forecasting” (with support from Performance and Finance). Actuary team will support Performance (and Finance) teams for the “within year” forecast.
- Lead the Reserving strategy and operations, including actuarial renegotiations with health plans, as needed, including performing the analysis underlying these negotiations. Recommend to CFO the least costly way to meet these reserve requirements, given health plan requirements and the financial forecast.
- Lead the analytics to support the company’s Contracting function, as described above. Will support the Strategic Payer Partnership team, which leads payer contracting. Under the overall guidance of the Strategic Payer Partnership team, the chief actuary will model different potential contract terms, advise the Strategic Payer Partnership team on overall negotiations, and lead actuarial negotiations with health plans. Once a contract is signed, the chief actuary and their team will lead actuarial negotiations with health plans during the reconciliation process.
- Lead the Benchmarking / market intelligence function, including translating market trends into actionable business insights.
- Create the Medical Economics Unit, including thinking carefully about how to use existing resources in Finance, Analytics, and Aledade+ to support the goals of the Medical Economics Unit. Two examples: (i) Understanding and projecting the impact of new prescription drug classes on Medicare Advantage spending. (ii) Imagine Aledade is scaling a pilot across its full population, the chief actuary will be responsible for projecting the pilot results across Aledade’s patient population. Finally, the Medical Economics Unit could play a key role in explaining Aledade’s performance to investors.
Minimum Qualifications:
- Proven experience as an actuarial leader in a healthcare setting, with a proven record of leading and motivating actuarial teams and 15+ years of relevant education + work experience.
- Deep familiarity with government healthcare programs and policies, particularly Medicare, Medicare Advantage, Medicaid, and the Affordable Care Act.
- Exceptional ability to communicate (oral, written) complex actuarial concepts and engage with various stakeholders, including health plan partners, other leaders at Aledade, and potential investors.
- Experience leading negotiations for multi-million dollar contracts.
- A strong record of collaboration at the executive level with other leaders, including working with colleagues on complicated, multi-group initiatives.
- Strong quantitative skills, including experience with statistical analysis and predictive modeling in healthcare contexts. Deep experience with Excel, Tableau, and other similar tools.
- Fellowship-Level Certification from the Society of Actuaries, or other similar credential.
- Experience leading actuarial or similar function at an organization that is “at risk” for the cost of medical care, such as an “at risk” provider system, payer, or contractor.
Preferred Knowledge, Skills and/or Abilities:
- Data manipulation skills, including working knowledge of SQL, R, and/or SAS programming.
- Relevant experience leading teams performing some or all of the key duties, listed above (forecasting, reserving, contracting, benchmarking, and creating the medical economics unit).
- Experience with healthcare data (e.g. claims, EHR, clinical).
- Experience analyzing data and communicating results in data visualizations, dashboards, and reports for a wide variety of audiences (company/ACO executives, internal staff, physicians, etc.).
- Passionate about driving the shift from fee-for-service to value-based care.
Top Skills
What We Do
Aledade is the largest network of independent primary care, enabling clinicians to deliver better patient outcomes and generate more savings revenue through value-based care. Aledade’s data, personal coaching, user-friendly workflows, health care policy expertise, strong payer relationships and integrated care solutions enable primary care organizations to succeed financially by keeping people healthy. Together with more than 1,900 practices and community health centers in 45 states and the District of Columbia, Aledade manages accountable care organizations that share in the risk and reward across more than 200 value-based contracts representing more than 2.5 million patient lives. To learn more, visit www.aledade.com or follow on X (Twitter), Facebook or LinkedIn.
Why Work With Us
At Aledade, we’re all about doing good for patients, practices and society - which is why we’re so passionate about value-based care and the work we do every day. Because we’re working to benefit all of society, we believe the best way to do so is to utilize all of our team members and their unique experiences, interests, backgrounds and beliefs.
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