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Vice President, Actuarial Services

Virtual

Hello, we’re Belong.

We partner with regional payers to deliver Medicare Advantage and Special Needs Plan products.

With a dual focus on data-driven, proactive clinical intervention and unwaveringly empathetic patient experience, Belong has completely reimagined health insurance for seniors and other Medicare-eligible individuals who have been disregarded and deprioritized for far too long.

We believe that only by recognizing individuals can we make communities strong.

Belong Health. Kinder, more supportive care.

SUMMARY

The Vice President of Actuarial Services will position Belong Health as an innovative and market leading company for analytic and reporting packages for value-based care/population health management. Oversees work related to actuarial functions such as underwriting, reserving, predicts future risks and helps the company create policies to minimize costs, mitigate future risk, and make underwriting/pricing decisions. Ensures that such plans are maintained on a financially sound basis.

ESSENTIAL JOB DUTIES AND RESPONSIBILITIES

  • Build executive performance and operational dashboards to provide visibility and access to key metrics, define targets for KPIs, and track progress against targets. 
  • Build and manage healthcare tools, savings methodologies and reporting. 
  • Identify and resolve data quality issues and maintain a robust measurement and reporting audit process for routine reports and measures. 
  • Implement and design risk stratification approaches, analysis of key metrics, and development of new analytics.
  • Utilizing payor data and reporting to generate VBC Performance monitoring
  • Setup and utilize Risk Accrual models to estimate final revenues from payors
  • Examine claims data to determine appropriate IBNR for VBC contracts
  • Help craft strategy for ACO and MAPD  
  • Responsible for developing policies, practices, and procedures that have a significant impact on organizational decisions. 
  • Incorporates new data sources, predictive modeling, and application of visualization tools. 
  • Represent Belong Health and our analytic capabilities with external provider partners and/or payors, to ensure they deeply understand current capabilities. 
  • Lead and direct the work of other employees including hiring, performance management, and coaching.  
  • Collaborate with other members of the executive management team to align departmental strategy or direction with the overall goals of the organization. 
  • Collect and analyze data to estimate the probability of certain events taking place. Uses estimations to develop, test, and administer policy adjustments based on these inferences. 
  • Perform other related duties as assigned. 

SUPERVISORY RESPONSIBILITIES

  • None

REQUIRED PROFESSIONAL EXPERIENCE AND QUALIFICATIONS

  • Has work experience in one or more of the following: Medicare Advantage, MSSP, ACO Reach, or other Value Based Care experience.
  • Has a proven track record of leading a highly skilled team that drive results.
  • Strong skills in collaborative working relationship with the team and stakeholders. 
  • Strong analytical, problem-solving, and business skills to extract implicit, unstated, and unrecognized requirements. 
  • Excellent verbal, written communication and presentation skills. 
  • Strong analytical and strategic skills required. 
  • Metrics driven. 
  • Ability to manage multiple priorities and projects. 
  • Must be proficient in SQL, Tableau, Microsoft Office. 
  • Demonstrate proactive service skills and effective stakeholder management.  
  • Self-starter with innate desire to learn. 

 PREFERRED PROFESSIONAL EXPERIENCE AND QUALIFICATIONS

  • An FSA designation is highly preferred. 

EDUCATION, TRAINING, LICENSE AND CERTIFICATION

  • Bachelor’s degree in health informatics, statistics, mathematics, finance, or related studies is required; Master's degree is preferred. 
  • 10 years of experience working in health care analytics is required with at least 5 years of experience in the clinical or managed care setting that is patient focused.  

WORK ENVIRONMENT

The work environment characteristics described here are representative of those encountered while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

  • The noise level in the work environment is usually quiet.
  • Most of the work is performed on a computer and in a sedentary environment.

TRAVEL

Limited Travel, scheduled per needs of the business.

SALARY

$225,000-$265,000 annually

Belong Health is an equal opportunity employer and encourages all applicants from every background and life experience to apply.

Our organization participates in E-Verify to confirm the eligibility of employees to work in the United States. (Nuestra organización participa en E-Verify para confirmar la elegibilidad de los empleados para trabajar en los Estados Unidos.)

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