Director, Actuarial Services

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

• 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

• 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 round tables, 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