Astrana Health vienija į bendruomenę orientuotas sveikatos priežiūros klinikas ir sveikatos priežiūros specialistams skirtą technologijų platformą, sukurtą pirminės, skubiosios ir kelių specializacijų medicinos pagalbai koordinuoti. Jos paslaugos padeda pacientams susisiekti su tinkle esančiais gydytojais ir kitais sveikatos priežiūros specialistais, o paslaugų teikėjams suteikia priežiūros koordinavimo bei išankstinio leidimo procesų valdymo priemones. Derindama klinikinę veiklą su sveikatos priežiūros komandoms sukurta technologija, Astrana Health daugiausia dėmesio skiria geresniam sveikatos priežiūros prieinamumui, pacientų patirčiai ir kasdieniam paslaugų teikimui.
Senior Actuarial Analyst, Health Plan Contracts
Astrana Health is seeking a senior actuarial analyst to model Medicare Advantage, Medicaid, and Commercial payer contracts. The role develops financial analyses, dashboards, and negotiation models to guide contract performance and strategy.
Aprašymas
- Model contracts across Medicare Advantage, Medicaid, and Commercial lines of business
- Develop detailed deal models that support health plan negotiations
- Apply analytics to strengthen the financial and operational performance of health plan contracts
- Monitor, forecast, and communicate the financial effects of payer agreements
- Create analytical infrastructure, reporting, and dashboards for payer financial performance
- Investigate legislation, market share, Star Ratings, bid strategy, and reimbursement developments
- Analyze benchmarking, contract optimization, investor relations, and risk adjustment topics
- Partner with Reserving, Analytics, Data, Finance, M&A, Contracting, Medical Economics, and Operations teams
- Report to the Senior Manager, Actuary
Reikalavimai
- Hold FSA or ASA credentials, or be close to attaining ASA credentials
- Bring at least 3 years of actuarial experience
- Have at least 1 year of experience in value-based care or a related field
- Demonstrate advanced proficiency with Microsoft Excel
- Demonstrate intermediate proficiency with SQL
- Be able and motivated to build actuarial models from the ground up
- Work effectively on a small team in a fast-paced setting
- Knowledge of health plan reimbursement methodologies is preferred
- Provider-side healthcare experience is preferred
- Experience with Medicare Advantage bid mechanics is preferred
- Risk adjustment experience is preferred
- Experience in the California healthcare market is preferred
- Understanding of the actuarial continuum, including pricing, forecasting, valuation, and reserving, is preferred
Privalumai
- Remote work is available from within the United States
- Hybrid work is available through offices in Alhambra, California; Las Vegas, Nevada; or Houston, Texas
- Actuarial Student Program support is available for candidates pursuing ASA or FSA credentials