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Aledade is the largest network of independent primary care.
The Role
The Director, Actuarial Services will oversee value-based care contracts, develop actuarial models, mitigate risks, and collaborate with cross-functional teams.
Summary Generated by Built In
The Director, Actuarial Services will apply a rigorous analytical approach to value-based care contracts, specifically focused on evaluating and managing and forecasting risk within Aledade’s Commercial and Medicaid contracts. This person will develop actuarial models to evaluate potential financial impacts under a wide range of performance scenarios that will be an input to our reporting and disclosure processes and will inform risk evaluation and mitigation efforts across all of Aledade.
This role will support and report to the Chief Actuary in leading the effort to develop more mature and formal actuarial and economic frameworks for evaluating value-based care contracts and deal terms, and translating high-level strategic targets and constraints into quantitatively defined perspectives on risk decision architecture across multiple lines of business. This role will also work closely with and support Aledade’s internal Finance and Performance teams.
We are flexible with respect to geographic location, and the ideal candidate will be comfortable working remotely in the United States.
Primary Duties
- Develop and enhance Commercial and Medicaid contracts forecast model, and lead monthly forecast process
- Work with contracting team to support contract negotiation including new contracts and contract renewal
- Develop and maintain an actuarial/economic framework for evaluating risk in value-based care contracts across Commercial and Medicaid contracts
- Identify risks that exceed specific thresholds and develop and present mitigation recommendations
- Interface cross-functionally and perform analyses to fulfill the requirements of other Aledade teams
Minimum Qualifications
- 12+ years in healthcare with health plans, provider groups or consulting firms and 8+ years doing healthcare actuarial analyses; experience in value-based care especially exposure to Commercial and Medicaid VBC models
- Bachelor’s degree in Finance, Economics, Actuarial Sciences, Statistics, Math or another quantitative field
- Fellow of the Society of Actuaries (FSA) or Associate of the Society of Actuaries (ASA) designation
Preferred KSA’s
- Master’s degree or other advanced degrees in finance, economics, actuarial sciences, statistics, math or another quantitative field
- Data manipulation skills, including strong experience with Excel and working knowledge of SQL, as well as at least basic skills with Python, R, and/or other similar analytics-oriented programming
- Experience with Google Workspace (Google Docs, Sheets, and Slides) as well as Microsoft Office (Word, Powerpoint, and Excel)
- Knowledge of standard methods for measuring health care utilization, spending, quality, and outcomes; risk adjustment, provider profiling, and related analytical tasks
- Strong ability to communicate actuarial concepts and results to a range of audiences including non-actuarial leaders and colleagues
- Demonstrated ability to independently lead and execute complex, high-visibility projects with multiple stakeholders
- Proven track record of creating, maintaining, and enhancing relationships and communicating effectively with senior management
- Intense attention to detail and extraordinary commitment to assurance of data quality and integrity for important work products
- Ability to think beyond their immediate team and contribute to making Aledade holistically better (active engagement in DE&I efforts, culture initiatives, facilitating training, leading roundtables, etc.)
- Experience with MA mechanisms and industry structure, including familiarity with STARS, the MA bid process, and the basic economics of the MA market
- Experience functioning in a highly matrixed organization and delivering complex, cross-functional projects
- Experience developing and applying consistent analytical frameworks to contracts in the value-based care space
- Experience in a fast-changing operational environment of a healthcare startup or similar
- Experience successfully managing a team
- Passionate about driving the shift from fee-for-service to value-based care and securing the future of independent primary care
- Experience working with projections of premiums, costs, MLR, and other aspects of MA forecasting
Physical Requirements
- Sitting for prolonged periods of time. Extensive use of computers and keyboard. Occasional walking and lifting may be required.
- Ability to travel
Who We Are:
Aledade, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of health plans, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place.
What Does This Mean for You?
At Aledade, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission.
In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:
Flexible work schedules and the ability to work remotely are available for many roles
Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners
Robust time-off plan (21 days of PTO in your first year)
Two paid volunteer days and 11 paid holidays
12 weeks paid parental leave for all new parents
Six weeks paid sabbatical after six years of service
Educational Assistant Program and Clinical Employee Reimbursement Program
401(k) with up to 4% match
Stock options
And much more!
At Aledade, we don’t just accept differences, we celebrate them! We strive to attract, develop and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit, qualifications, performance and business needs. All qualified candidates will receive consideration for employment without regard to age, race, color, national origin, gender (including pregnancy, childbirth or medical conditions related to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation.
Privacy Policy: By applying for this job, you agree to Aledade's Applicant Privacy Policy available at https://www.aledade.com/privacy-policy-applicants
Top Skills
Excel
Python
R
SQL
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The Company
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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