Candidates must be legally authorized to work in the United States without employer sponsorship, now or in the future.
The Actuarial Manager, Tools and Models will own the core actuarial models and tools used for reserving and forecasting claims across agilon's Medicare Advantage (MA) and value-based care populations. The Manager will help support the development of actuarial analysts through direct management and project leadership. The Manager will actively monitor and assess data quality, drive enhancements to Medical Margin Models, and enhance standardized reporting tools for close results at the market and national levels.
The Manager will play a central role in the annual budget process, including trend studies and the use of payor bid data to quantify year-over-year benefit changes and recommend trend adjustments for benefit relativity. As CMS transitions the ACO REACH program to ACO LEAD, the Manager will help design and build the actuarial models supporting the new program.
This is a fully remote position, with minimal required travel. This role reports to the Sr. Director for the Central Actuarial team. The Central team develops and maintains models, tools, and methodology that underpin the monthly close process that is carried out by the Markets team. The role is critical to the operations of the Actuarial team, and the Manager will be a key leader within the Actuarial and broader Data Solutions organization.
Essential Job Functions:
- Develop and maintain actuarial models and tools
- Actively monitor and assess data quality
- Drive enhancements to Medical Margin Models, including IBNR and revenue accrual methodology
- Evaluate and set claims completion factors quarterly for national payors
- Develop and maintain standardized reporting tools for close results utilizing statements data and/or payor data feeds
- Support development of the annual budget, including trend studies and key claims assumptions
- Leverage payor bid data to quantify year-over-year benefit design changes and recommend claims trend adjustments for benefit relativity
- Support the design and build-out of actuarial models for the ACO LEAD program as CMS guidance emerges
- Collaborate with Markets Actuarial teams to identify changes in national claims trends and drivers of prior period development
- Co-lead project intake, prioritization, and progress tracking across the Markets Actuarial and Central Actuarial teams
- Manage / mentor junior actuarial analysts
- Review and update internal / external audit documentation
- Support build-out of improved actuarial team processes
Other Job Functions:
- Develop talent through coaching, mentorship, and technical review
- Collaborate with Market Finance, FP&A, Accounting, Med Econ, and others
- Identify critical issues and recommend solutions to business problems
- Contribute to team priority-setting aligned with goals established by upper management
- Exemplify the core values of agilon health
Required Qualifications:
- Minimum Experience
- 6+ years of actuarial experience (8+ years preferred)
- Demonstrated leadership via project ownership and cross-functional initiatives, mentoring analysts, serving as a trusted delegate for a senior leader, and/or prior people management
- Education/Licensure
- ASA or FSA designation
- Bachelor's degree
Knowledge, Skills, and Abilities:
- Strong model building mindset; model flow, ease of use, auditability, etc.
- Experience with reserving, forecasting, and trend development
- Excellent ability to communicate actuarial methodology, both written and verbal
- Strong understanding of Medicare Advantage; ACO REACH or MSSP background is a plus
- Understanding of MA health plan data (Claims, MMR, MAO-004, etc.)
- Proficiency with Excel and SQL
- Experience presenting actuarial/financial concepts to a non-technical audience
- Proven problem-solving skills (identification of issue, causes, solution, implementation plan)
- Proven ability to influence, grow, and motivate others
- Entrepreneurial and innovative spirit
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Location: Remote - COPay Range: $129,700.00 - $162,100.00Salary range shown is a guideline. Individual compensation packages can vary based on factors unique to each candidate, such as skill set, experience, and qualifications.
Skills Required
- 6+ years of actuarial experience
- ASA or FSA designation
- Bachelor's degree
- Demonstrated leadership through project ownership, cross-functional initiatives, analyst mentoring, senior-leader delegation, or people management
- Experience with reserving, forecasting, and trend development
- Strong understanding of Medicare Advantage
- Understanding of Medicare Advantage health plan data, including Claims, MMR, and MAO-004
- Proficiency with Excel and SQL
- Ability to communicate actuarial methodology to non-technical audiences
- 8+ years of actuarial experience
- ACO REACH or MSSP background
agilon health Compensation & Benefits Highlights
The following summarizes recurring compensation and benefits themes identified from responses generated by popular LLMs to common candidate questions about agilon health and has not been reviewed or approved by agilon health.
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Strong & Reliable Incentives — Bonuses and stock grants are described as superior to other workplaces and part of “excellent” packages for some roles. Incentive components are credited with elevating overall compensation in certain areas.
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Leave & Time Off Breadth — Unlimited PTO, generous holidays, and occasional wellness or volunteer days are highlighted across parts of the organization. These elements create wide latitude for time away when team norms allow.
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Retirement Support — A 401(k) with a significant company match is emphasized, with some accounts noting immediate vesting. This strengthens the long-term savings value of the package.
agilon health Insights
What We Do
agilon health is transforming health care for seniors by empowering primary-care physicians to focus on the entire health of their patients. Through our platform and partnership model, agilon health is leading the nation in creating the system we need – one built on the value of care, not the volume of fees. We honor the independence of local physicians and serve as their long-term partner so they can be the physicians they trained to be. agilon is built for physicians by physicians, as the patient-physician relationship is the cornerstone of care. We allow primary care physicians to take the long view of their relationships with patients, and to be confident in the long-term financial viability of their own practices. We do this through a Total Care Model that maintains the independence of physicians; unites them in a network of like-minded leaders; and integrates all of the components of a global risk business model into a single platform.
