Regional Manager, Actuarial Services

Job Description: ​

agilon health is building out our Actuarial function and actively seeking to bring on a Remote Regional Managers of Actuarial Services, supporting one of our three regions. (one opening!)

Ideal candidate has strong experience in Medicare Advantage as well as experience directly involved in MA bids (Part-D plus, not required) or experience in supporting MA bidding during any of the process. ASA or FSA designation required - Only candidates meeting minimal qualifications listed below will be considered

Position Summary:

Our Actuarial Market Managers will each lead a team of market analysts in preparing medical margin models monthly and presenting results to the Market Finance team. This manager will attend regional JOCs to better understand nuances and drivers of market level trends. The Actuarial Market Manager will help to inform the annual budget/quarterly forecasts. Additionally, they will support the build-out of improved models and processes for the actuarial team.

Essential Job Functions:

• Lead and support a team of analysts that represent respective markets
• Attend Joint Operational Committee meetings (JOCs) to gain in depth knowledge of markets
• Inform reserve setting assumptions
• Review MA & ACO medical margin by market and identify common themes/outliers
• Present trends/PPD drivers to Market Finance team
• Inform annual budget/quarterly forecasts
• Provide guidance on business development/payer contracting assumptions
• Support build-out of improved actuarial team processes
• Support Market Finance requests/analyses
• Support conversations with health plans to address financial statement data issues/interpretation
• Review final cash settlements for MA payer contracts
• Review internal/external audit documentation

Other Job Functions:

• Grow and lead talent
• Exemplify companies’ core values
• Collaborate with Market Finance, FP&A, Accounting, Med Econ, and others
• Identifies critical issues and recommends solutions to business problems.
• Sets team objectives for assigned unit/area aligned with goals set by upper management
• Performs complex tasks typically following current established processes, while supporting the implementation of and adherence to new and/or evolved processes

Required Qualifications:

Minimum Experience

• 5 years of actuarial experience
• Demonstrated leadership capability, has previously led others

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 forecasting
• Experience with value-based arrangements is a plus
• Proficiency with Excel and SQL
• Proven ability to work in a fast-paced environment where internal/external client satisfaction is key
• 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