Central Director, Actuarial Services

Company:

AHI agilon health, inc.

Job Posting Location:

Remote - USA

Job Title:

Central Director of Actuarial Services

Job Description:

Position Summary:

The remote Central Director of Actuarial Services will lead a team of managers responsible for centralized actuarial functions and modeling. He/she will first help to build up improved centralized reserving/medical margin models for the market actuarial team’s use. Then, the Central Director of Actuarial Services will oversee reserve setting at the national MA payer level as well as oversee market level RAF projections. This individual will provide guidance on the projection of ACO medical margin estimates and report drivers of prior period development to senior leadership. All of this will be done with the mindset of continued improvement of processes and coordination across the actuarial team.

Essential Job Functions:

• Lead a team of managers responsible for centralized actuarial functions/models
• Oversee reserve setting for membership belonging to national Medicare Advantage payers
• Review ACO medical margin estimates
• Review and advise on RAF accrual estimates; including modeling and data inputs
• Stay apprised of CMS changes to ACO program and risk adjustment regulations
• Report drivers of prior period development to Chief Actuary and other senior leaders
• Support build-out of improved actuarial team processes/models
• Lead connection with Market Actuarial Director and team to educate on centralized model/assumption changes
• Advise on internal/external audit documentation changes
  
  

Other Job Functions:

• Grow and lead talent
• Exemplify companies’ core values
• Collaborate with Market Finance, FP&A, Accounting, Med Econ, and others
  
  

Required Qualifications:

Minimum Experience

• 8 years of actuarial experience
• Demonstrated leadership capability, has previously led sizeable staff
• Experience in leading other managers
  
  

Education/Licensure

• ASA or FSA designation
• Bachelor’s degree in Actuarial Science, Math, Economics or related field
  
  

Knowledge, Skills, and Abilities:

• Excellent communication, both written and verbal
• Strong understanding of Medicare Advantage and bidding process (Part D knowledge is a plus)
• Understanding of MA health plan data (Claims, MMR, MAO-04, etc.)
• Experience with reserving and risk adjustment modeling
• Experience with value-based arrangements
• Proficiency with Excel and SQL
• Proven ability to work in a fast-paced environment where internal/external client satisfaction is key
• Experience interacting with senior leadership
• Proven problem solving skills (identification of issue, causes, solution, implementation plan)
• Proven ability to influence, grow, and motivate others
• Entrepreneurial and innovative spirit
  
  

Location:

Austin, TX

Pay Range:

$153,000.00 - $191,300.00

Salary range shown is a guideline. Individual compensation packages can vary based on factors unique to each candidate, such as skill set, experience, and qualifications.