Aledade18mo ago

Chief Actuary, Remote

United StatesRemoteFull Timeexecutive

Data ScienceOtherActuary

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Requirements Summary

(a). Benchmarking / market intelligence. Understand actuarial trends of Aledade peer companies, health plans, and other relevant market participants. Translate those trends

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Data ScienceOtherActuary

The Chief Actuary at Aledade is a key leadership position responsible for leading the actuarial function at Aledade. There are three primary functions, and two secondary activities. The primary functions are: (1). Forecasting. Looking across all of Aledade’s business, predict revenue and costs at various timescales, and build statistical models to determine how variable this forecast is. (2). Reserving. Working closely with our Strategic Payer Partnership and Finance teams, develop a strategy for Aledade to satisfy financial reserve / letters of credit requirements from health plans and lead actuarial negotiations. (3). Contracting. Develop the actuarial machinery to evaluate the financial terms of contracts with health plans, including assessing the financial risk and the impact that this contract will have on our reserving requirements.

There are two secondary functions: (a). Benchmarking / market intelligence. Understand actuarial trends of Aledade peer companies, health plans, and other relevant market participants. Translate those trends into (i) assumptions that feed the short and long-run forecasts and that inform resource planning and (ii) implications to inform Aledade’s operations. (b). Medical Economics Unit. Build the capacity to understand the key drivers of costs in Aledade’s “at risk” population and formally track efforts at Aledade to impact those trends, which impacts forecasting.

As a senior leader at Aledade, the Chief Actuary will actively promote a culture that aligns with Aledade and team values, and will coach and mentor other team members - both within Analytics and the broader company.

We are flexible with respect to geographic location in the United States, and the ideal candidate will be comfortable working remotely in the United States with considerable amounts of travel.

Provide visionary leadership for and management of the actuary team, including forming close partnerships with the six main teams (Strategy Payer Partners, Finance, Performance, Policy, Aledade+, and the other parts of Analytics) to support other duties.

Lead Aledade’s Forecasting efforts, including working with Finance, Performance, Policy and other Analytics teams. Actuary team will lead the “future years forecasting” (with support from Performance and Finance). Actuary team will support Performance (and Finance) teams for the “within year” forecast.

Lead the Reserving strategy and operations, including actuarial renegotiations with health plans, as needed, including performing the analysis underlying these negotiations. Recommend to CFO the least costly way to meet these reserve requirements, given health plan requirements and the financial forecast.

Lead the analytics to support the company’s Contracting function, as described above. Will support the Strategic Payer Partnership team, which leads payer contracting. Under the overall guidance of the Strategic Payer Partnership team, the chief actuary will model different potential contract terms, advise the Strategic Payer Partnership team on overall negotiations, and lead actuarial negotiations with health plans. Once a contract is signed, the chief actuary and their team will lead actuarial negotiations with health plans during the reconciliation process.

Lead the Benchmarking / market intelligence function, including translating market trends into actionable business insights.

Create the Medical Economics Unit, including thinking carefully about how to use existing resources in Finance, Analytics, and Aledade+ to support the goals of the Medical Economics Unit. Two examples: (i) Understanding and projecting the impact of new prescription drug classes on Medicare Advantage spending. (ii) Imagine Aledade is scaling a pilot across its full population, the chief actuary will be responsible for projecting the pilot results across Aledade’s patient population. Finally, the Medical Economics Unit could play a key role in explaining Aledade’s performance to investors.

Proven experience as an actuarial leader in a healthcare setting, with a proven record of leading and motivating actuarial teams and 15+ years of relevant education + work experience.

Deep familiarity with government healthcare programs and policies, particularly Medicare, Medicare Advantage, Medicaid, and the Affordable Care Act.

Exceptional ability to communicate (oral, written) complex actuarial concepts and engage with various stakeholders, including health plan partners, other leaders at Aledade, and potential investors.

Experience leading negotiations for multi-million dollar contracts.

A strong record of collaboration at the executive level with other leaders, including working with colleagues on complicated, multi-group initiatives.

Strong quantitative skills, including experience with statistical analysis and predictive modeling in healthcare contexts. Deep experience with Excel, Tableau, and other similar tools.

Fellowship-Level Certification from the Society of Actuaries, or other similar credential.

Experience leading actuarial or similar function at an organization that is “at risk” for the cost of medical care, such as an “at risk” provider system, payer, or contractor.

Data manipulation skills, including working knowledge of SQL, R, and/or SAS programming.

Relevant experience leading teams performing some or all of the key duties, listed above (forecasting, reserving, contracting, benchmarking, and creating the medical economics unit).

Experience with healthcare data (e.g. claims, EHR, clinical).

Experience analyzing data and communicating results in data visualizations, dashboards, and reports for a wide variety of audiences (company/ACO executives, internal staff, physicians, etc.).

Passionate about driving the shift from fee-for-service to value-based care.