Director Actuarial Services

Position: Director Actuarial Services  

The Director, Actuarial Services is a dynamic role that will provide leadership and have a high level of expertise in actuarial modeling of VBC programs. This role will partner with key stakeholders across medical economics, clinical and client partnership functions. They will have a strong skillset in managing forecast assumptions and interpreting financial results. Will be in Nashville, TN or Remote.

Role summary 

• Report to VP of Actuarial Services
• Work in a fast-paced environment gaining experience with VBC models
• Collaborates with team members from strategy, clinical and new market functions to identify data driven opportunities to add value to existing and potential partners
• Develop analytical tools to identify meaningful trend drivers, with linkage to financial results
• Work with legal and business development to outline value based economics for contracts.

Responsibilities 

• Applies fundamental actuarial principles in analyzing healthcare claims data 

• Develop, maintain, and analyze projection models 

• Reconcile value-based care settlements. 

• Coordinate with external actuaries and report monthly results. 

• Maintain valuation model for opportunity analysis 

• Establish actuarial procedures and document for internal use 

Required Qualifications 

• Bachelor’s degree in actuarial science, mathematics, or related field 

• Associate of the Society of Actuaries 

• 8-10 years healthcare experience 

•  Experience with Value-Based Healthcare economics and different Value-Based Care arrangements. 

•  Experience with CMS HCC risk score model for non-ESRD and ESRD populations.  

•  Proficiency in MS Excel for building actuarial models and summarized revenue and claims reports  

•  Strong familiarity with R/Python/SQL 

Preferred Qualifications 

• Fellow of the Society of Actuaries 

• Medicare Part C bid pricing experience 

Benefits   

• Comprehensive Benefits - Medical, dental, and vision insurance, employee assistance program, employer-paid and voluntary life insurance, disability insurance, plus health and flexible spending accounts
• Financial & Retirement Support – Competitive compensation, 401k with employer match, and financial wellness resources
• Time Off & Leave – Paid holidays, flexible vacation time/PSSL, and paid parental leave
• Wellness & Growth – Work life assistance resources, physical wellness perks, mental health support, employee referral program, and BenefitHub for employee discounts

About Monogram Health

Monogram Health is a leading multispecialty provider of in-home, evidence-based care for the most complex of patients who have multiple chronic conditions. Monogram health takes a comprehensive and personalized approach to a person’s health, treating not only a disease, but all of the chronic conditions that are present - such as diabetes, hypertension, chronic kidney disease, heart failure, depression, COPD, and other metabolic disorders. 

Monogram Health employs a robust clinical team, leveraging specialists across multiple disciplines including nephrology, cardiology, endocrinology, pulmonology, behavioral health, and palliative care to diagnose and treat health issues; review and prescribe medication; provide guidance, education, and counselling on a patient’s healthcare options; as well as assist with daily needs such as access to food, eating healthy, transportation, financial assistance, and more. Monogram Health is available 24 hours a day, 7 days a week, and on holidays, to support and treat patients in their home.

Monogram Health’s personalized and innovative treatment model is proven to dramatically improve patient outcomes and quality of life while reducing medical costs across the health care continuum.