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Director, Actuary and Healthcare Economics

Remote

At Diverge Health we are a team of entrepreneurs passionate about improving health access and outcomes for those most in need. We partner with primary care providers to improve the engagement and management of their Medicaid patients, providing independent practices access to specialized resources and clinical programs to address medical, social and behavioral patient needs. Our care ecosystem is equipped with enhanced technology and data interfaces to enable provider and patient success in a value-based environment. Guided by our core values of humility, continuous learning and feeling the weight, our team is on a mission to strengthen communities from within, unlocking people's ability to live their healthiest lives. 

At Diverge Health we are a team of entrepreneurs passionate about improving health access and outcomes for those most in need. We partner with primary care providers to improve the engagement and management of their Medicaid patients, providing independent practices access to specialized resources and clinical programs to address medical, social and behavioral patient needs. Our care ecosystem is equipped with enhanced technology and data interfaces to enable provider and patient success in a value-based environment. Guided by our core values of humility, continuous learning and feeling the weight, our team is on a mission to strengthen communities from within, unlocking people's ability to live their healthiest lives.  

 

We are seeking a Director, Actuary and Healthcare Economics to join our team! 

Reporting to the Vice President of Finance, you will be responsible for developing and maintaining actuarial models to assess risk, forecast financial outcomes, and support performance of value-based contracts.  With strong experience working with claims data, you will help develop and implement new techniques and tools to analyze and forecast healthcare economics. 

What you’ll do 

As a Director, Actuary and Healthcare Economics at Diverge, you will collaborate closely with cross-functional teams, including technology, population health, payer contracting, finance, and market operations, to integrate analytical insights into business decisions. You will manage key financial processes related to unpaid claims liability, medical expense accruals, and revenue accruals while ensuring compliance with regulatory requirements. Additionally, you will drive innovation in healthcare economics, enhance actuarial modeling capabilities, and oversee data management for accurate reporting and forecasting.  

 

Key areas you’ll add value: 

  • Financial Forecasting: Prepare and present detailed actuarial reports and financial forecasts to senior management and stakeholders. Provide insights and recommendations based on actuarial analysis to inform business decisions.
  • Actuarial Estimation: Develop, refine, maintain, summarize, and communicate actuarial models to assess risk, forecast financial outcomes, and support strategic initiatives. Ensure models are accurate, up-to-date, and aligned with industry best practices.
  • Risk-bearing entity financial support: Collaborate with finance and accounting on monthly processes for unpaid claims liability estimations, medical expense accruals and revenue accruals.
  • Healthcare Economics reporting and analytics: Work closely with cross-functional teams, including finance, accounting, population health, clinical, operations, and technology to produce reporting assets and provide ad-hoc analytics that evaluate medical expense and premium performance for risk-based contracts.
  • Innovate: Drive the development of new healthcare economics analysis techniques and tools to enhance analytical capabilities and support the company's growth objectives.
  • Leadership: This role is intended to grow into a functional leader with oversight over actuaries and healthcare economics analysts.
  • Collaboration: Integrate analytical insights into business strategies and operations by partnering with Clinical, Population Health, Operations, Technology, and Finance
  • Compliance: Ensure that all actuarial practices comply with regulatory requirements and industry standards. Stay informed about changes in legislation and adjust models and practices accordingly.
  • Data Management: Oversee the collection, validation, and analysis of healthcare data in collaboration with Technology and Finance. Ensure data integrity and accuracy in all reporting and modeling activities.

 

What you’ll bring 

  • Education: Bachelor’s degree in Actuarial Science, Mathematics, Statistics or a related field. Professional actuarial certification ASA required, FSA preferred.
  • Experience:Minimum of 8 years of actuarial experience within a healthcare and/or managed care organization with significant experience in Medicaid products. Experience with value-based reimbursement strategies and affordability initiatives preferred.
  • Skills:Strong technical skills with proficiency in actuarial software, statistical tools, data analysis, and healthcare data management. Excellent problem-solving abilities and a deep understanding of risk management and financial forecasting.
  • Communication:Outstanding written and verbal communication skills, with the ability to convey complex actuarial concepts to non-technical stakeholders. Strong business acumen and interpersonal skills.
  • Adaptability:Ability to thrive in a fast-paced, dynamic startup environment. Willingness to take on diverse responsibilities and drive results in a growing organization.
  • Dynamic Attitude: An effective leader that can both manage and execute.

 

Who we’re looking for 

Personal Characteristics include but are not limited to 

  • Equally empathetic and objective, humble and highly conscientious; a teammate that inspires and motivates others. 
  • Comfort with uncertainty; self-motivated and directed; can manage effectively in high growth, rapidly evolving environments. 
  • A problem solver, able to think critically and strategically while being hands on in driving work; proactively identifies and resolves risks to execution and delivery. 
  • Strong representation of the company's mission, vision, and values across all dimensions of internal and external interactions. 
  • Strength in authentically connecting with people from all walks of life with empathy and humility. 
  • Possess exceptional organizational skills and excels in clear, effective communication with key stakeholders. 

Our Investors

Diverge Health is funded by GV and incubated by Triple Aim Partners, which since 2019 has partnered with entrepreneurs to co-found and launch eight companies focused on improving the quality, experience and total cost of healthcare.

At Diverge Health we believe that a diverse set of backgrounds and experiences enrich our teams and enable us to realize our mission. If you do not have experience in all areas detailed above, we encourage you to share your unique background with us and how it might be additive to our team.

Special Considerations 

Diverge Health is dedicated to the principles of Diversity, Equity and Inclusion and Equal Employment Opportunities for all employees and applicants for employment. We do not discriminate on the basis of race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, reproductive health decisions, family responsibilities or any other characteristic protected by the federal, state or local laws. Our decision to hire, promote, discipline, or discharge, will be based on merit, competence, performance and business needs.

 

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