ABOUT THE JOB
The Actuary will be one of strategic importance to the future of Marathon Health in that this role helps summarize likely clinic costs, estimate healthcare benefits that clients can expect to receive, and then to demonstrate the value that clients receive from Marathon Health. This position will help the industry transform healthcare by helping the organization and clients understand the facts related to both healthcare improvement (via electronic medical records and other health information) as well as health care costs (via claims) - all made possible by a proven approach of offering primary care services through employers. This information should also help providers to continuously improve the impact that the health centers can make. The ideal candidate will be energized by the opportunity to use information and insights to proactively identify opportunities to continuously improve the Marathon Health business model and demonstrate the value of the services provided.
ESSENTIAL DUTIES & RESPONSIBILITIES
Work with claims history and Marathon Health clinic experience to estimate likely clinic savings
- The Actuary will need to understand the history of medical claims for each client and their performance in key categories relative to norms (primary care, urgent care, emergency rooms, etc.)
- This analysis would include the full range of medical claims and all potential segments including but not limited mental health, dental, physical therapy, etc.
This position will recommend pricing that: achieves targeted levels of contribution, considers the client's forecast ROI and competition
- The Actuary will develop pricing recommendations considering company margins, client expected ROI, and market competition.
- The Actuary will deliver these recommendations to the Senior Actuary for review.
Use insights from all work to proactively identify opportunities to demonstrate value for clients and process improvements (re: clinic operations, clinical outcomes and other factors affecting ROI)
- This position has access to a wide range of important cost, benefit, and clinical information in aggregate and for each clinic.
- An important part of this position will be to use this information to proactively look for and identify opportunities for improvement.
Analyze health care cost claims and clinic expenses to estimate total savings for clients each year
- This role will also be responsible for providing the reporting necessary for the annual reports to clients on actual claims and clinical experience.
Analyze contractual performance guarantees and project future liabilities and results
- This role will also be responsible for providing the reporting necessary for the performance guarantees to clients on actual claims and clinical experience.
QUALIFICATIONS
Bachelor's degree in Finance/Accounting/Math/Actuarial Science/Economics and a minimum of 5+ years of corporate actuarial experience or equivalent combination of education and experience. ASA Required. Notable expertise with Microsoft Excel is required; familiarity with data query/data management tools preferred (Access, SQL, Tableau).
DESIRED ATTRIBUTES
- Strong financial modeling experience
- Significant experience working with healthcare claims (and EMR data) in aggregate and in organizing large amounts of raw data into meaningful categories
- Healthcare actuarial training and experience to accurately summarize the implications of claims analytical findings and identify opportunities and risks
- The ability to work well with and proactively with cross-functional team members across the organization to gather information, request assistance when needed, and provide support when needed, etc.
- Strong understanding of medical diagnostic and procedure codes with the ability to organize large amounts of claims data and clinical data from the EMR using actuarial sound approaches and principles
- The person in this position will need to collaborate well on a cross-functional basis with multiple key stakeholders.
Pay Range: $110,000 - $150,000/yr
The actual offer may vary dependent upon geographic location and the candidate's years of experience and/or skill level.
We are accepting applications for this position until a candidate has been selected. To apply to this position and learn more about open jobs at Marathon Health, visit our careers page.