Finance- Senior Actuarial Analyst

Senior Actuarial AnalystJob Summary:The Senior Actuarial Analyst will play a pivotal role in ArchWell Healths growth and within the Actuarial Department. This Analysts contribution will be key to the organizations collective success. This role will work closely and collaboratively with various departments providing insights that support strategic business decisions and optimize financial performance. DepartmentDuties/Responsibilities:Risk Adjustment and Revenue Performance:Develop and maintain models to forecast risk-adjusted revenue across Medicare Advantage contractsAnalyze historical risk score trends RAF accuracy and coding opportunities to identify gaps and performance driversSupport the annual budget process quarterly projections monthly accruals and variance explanationsEvaluate the impact of HCC model updates and CMS rule changes on organizational revenuePerform Ad-hoc Revenue Analysis to evaluate financial impacts of operational initiatives clinical programs membership shifts and emergent business questionsReserving and Monthly Close processes:Assist in monthly IBNR development and selection necessary monthly reporting as a key contributor within the monthly closing and Modeling:Develop and maintain models to forecast future medical cost and revenue and/or evaluate the financial impact of various with department heads to understand key business drivers and assumptions ensuring alignment with strategic comprehensive financial reports and variance analyses for senior management and key ad hoc financial analyses to support special projects strategic initiatives and investment Analysis:Analyze payor healthcare data (claims utilization costs) to identify trends cost drivers and opportunities for to end payor reconciliations (detail vs summary external vs internal data feeds and additional reconciliation as needed).Payor outreach and internal point of contact related to file requests data gaps and other supplemental reporting and information available Business Performance Monitoring:Monitor and analyze key performance indicators (KPIs) and operational metrics to assess business performance and identify areas of with operational teams to develop actionable insights and recommendations for performance enhancement and risk the cost-effectiveness and value of different healthcare interventions programs and in the development of executive-level dashboards and reporting tools to track financial and operational performance against -Functional Collaboration:Collaborate cross-functionally with IT finance accounting operations and other departments to streamline processes improve data accuracy and enhance financial reporting Skills/Abilities:Prior experience within Medicare AdvantageUnderstanding of CMS-HCC models (v24/v28) CMS risk adjustment methodology and RAF score calculationProficiency in modeling forecasting and/or variance analysisAdvanced proficiency in Microsoft ExcelPrior usage and strong understanding of SQL (2 years preferred)Understanding of profit and loss statements and ability to work with larger datasets behind them Analytical problem-solving and critical thinking skillsAbility to work effectively in a fast-paced dynamic environment and managing multiple priorities simultaneouslyStrong interpersonal skills with the ability to collaborate cross-functionally and build positive working relationships at all levels of the travel required no more than 10%-15%Minimum Qualifications:Bachelors degree in Actuarial Science Mathematics Statistics Finance Economics or related field required; MBA or advanced degree least of 3-6 years relevant Actuarial experience within healthcare preferred.2 Actuarial Exams Pre-ASA or ASA levelEmbodies and serves as a role model of ArchWell Healths Values: Be compassionateStrive for excellenceEarn trustShow respectStay resilientAlways do the right thingAbout ArchWell Health:At ArchWell Health were creating a community of caring designed to help our members stay healthy and engaged. By focusing on a strong provider-patient relationship routine wellness and staying active our members enjoy a higher level of care and better quality of life after the age of 60. Everything we do is for seniors. We believe seniors should be heard listened to and given ample time by their physicians to live well later in value-based care model is designed to prevent illnesses while keeping members healthy and happy in every aspect of their life. We deliver best-in-class primary care at comfortable accessible neighborhood centers where older adults can feel at home and become part of a vibrant wellness-focused community. Were passionate about caring for older adults and united by the belief that caring has the power to change everything for our Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to their race color religion age sex sexual orientation gender identity national origin disability veteran status or any other protected classification.