Actuarial Manager

WELLBE INTRODUCTION

WellBe Senior Medical is an innovative, private equity backed healthcare company focused on providing the highest quality geriatric care (care of older adults) to frail, elderly Medicare Advantage patients with multiple chronic medical conditions. This population is typically underserved and very challenged with access to quality care. To address these problems, WellBe has elected to bring the care to the patient, instead of trying to bring the patient to the care. Care is provided throughout the entire continuum of care – from chronic care and urgent care in the home, to hospital, to skilled nursing facility, to assisted living, to palliative care, to end of life care. WellBe's physician-led geriatric care teams provide “concierge” level geriatric medical care and social support in the home as well as delivering and coordinating care across the entire continuum.

GENERAL JOB SUMMARY

This is a highly unique role at an innovative, fast-growing, private equity backed healthcare company. As the second actuarial employee under our Head of Actuarial Services, you will be tasked with helping to build the actuarial function from the ground-up. This job has significant long-term growth opportunity.

We are looking for an Actuarial Manager to join our team and support our actuarial functions. In this role, you will be responsible for developing actuarial eligibility and claims analyses, IBNR model development, revenue analysis and forecasting, providing support in value-based contract negotiations, coding for data processing, and any other ad-hoc analyses. They will in partnership with Finance and Market leadership develop annual budgets and reforecasts. This person will provide actuarial insight to improve WellBe’s performance under full-risk contracts. The ideal candidate will have strong analytical skills, experience in healthcare actuarial analysis, and excellent communication skills.

Responsibilities:

• Build actuarial eligibility and claims analyses to support the business's strategic initiatives
• Process and summarize Medicare Advantage eligibility, claims, and revenue data from our plan partners
• Develop and maintain accurate IBNR models to inform financial reporting and forecasting
• Conduct revenue analysis and forecasting to inform business decision-making and strategic planning
• Provide actuarial support in value-based contract negotiations with payers
• Code and perform data processing to ensure efficient data management and analysis
• Collaborate with cross-functional teams to understand business needs and inform actuarial analyses
• Identify trends and opportunities for improvement in actuarial processes and analytics
• Present findings and recommendations to internal stakeholders, including senior management

QUALIFICATIONS

Educational and Experience Requirements:

• Bachelor’s Degree in Actuarial Science, Mathematics, Statistics, or related field
• ASA, MAAA preferred
• 5+ years of experience in healthcare actuarial analysis
• Preferred experience working in Medicare Advantage
• Experience with actuarial modeling and forecasting

Required Skills and Abilities:

• Strong analytical skills, including proficiency in Excel and coding
• Demonstrated ability to lead a project
• Excellent communication and presentation skills, with the ability to explain complex actuarial concepts to both technical and non-technical stakeholders
• Detail-oriented with the ability to manage multiple projects and prioritize effectively
• Demonstrated ability to accurately project IBNR
• Demonstrated understanding of risk-based contracting and performance analysis
• Understanding of Medicare Advantage

Supervisory Responsibility: This position will have no direct reports at this time, but the role could expand if the individual demonstrates excellent performance.

Travel requirements: Travel may be required up to 10% locally or nationally

Work Conditions: Ability to lift up to 20lbs. WellBe is currently working in-person in the office. Partial work from home is a possibility after demonstrated strong performance.

The preceding functions may not be comprehensive in scope regarding work performed by an employee assigned to this position classification. Management reserves the right to add, modify, change, or rescind the work assignments of this position. Management also reserves the right to make reasonable accommodations so that a qualified employee(s) can perform the essential functions of this role.