Role Summary

HIGHLIGHTS

Director-level health actuarial role in Chicago focused on value-based care for Medicare Advantage, Medicaid, and commercial contracts. Lead actuarial modeling, RAF forecasting, and contract risk evaluation to inform contracting, performance monitoring, and enterprise risk strategy. Collaborate with finance, growth, clinical, coding, and data science teams. Hybrid role with preference for candidates within 50 miles of Chicago.

JOB DESCRIPTION SUMMARY

Lead actuarial modeling and financial forecasting for Medicare Advantage, MSSP/REACH, and Medicaid
Design and evaluate value-based payment models including shared savings and capitation
Own enterprise risk adjustment strategy and prospective RAF forecasting
Partner with contracting, clinical, coding, finance, and data science teams
Hybrid: 2 days onsite in Chicago, 3 days remote (fully remote considered outside 50-mile radius)

DOMAIN EXPERTISE

value-based care contracts and shared savings/capitation models
MSSP/ACO REACH and Medicare Advantage operations
risk adjustment and RAF forecasting
MA STARS and MA bid process familiarity
projections of premiums, costs, MLR, and MA forecasting

KEY REQUIREMENTS

8+ years in healthcare and 5+ years doing healthcare actuarial analyses
ASA or FSA designation required
Deep experience with Medicare Advantage, MSSP/ACO REACH, and Medicaid value-based programs
Strong data skills with SAS and SQL; familiar with R and Python
Bachelor’s degree required; master’s preferred

TECH STACK

Excel
PowerPoint

Role Summary

HIGHLIGHTS

JOB DESCRIPTION SUMMARY

Lead actuarial modeling and financial forecasting for Medicare Advantage, MSSP/REACH, and Medicaid
Design and evaluate value-based payment models including shared savings and capitation
Own enterprise risk adjustment strategy and prospective RAF forecasting
Partner with contracting, clinical, coding, finance, and data science teams
Hybrid: 2 days onsite in Chicago, 3 days remote (fully remote considered outside 50-mile radius)

DOMAIN EXPERTISE

value-based care contracts and shared savings/capitation models
MSSP/ACO REACH and Medicare Advantage operations
risk adjustment and RAF forecasting
MA STARS and MA bid process familiarity
projections of premiums, costs, MLR, and MA forecasting

KEY REQUIREMENTS

8+ years in healthcare and 5+ years doing healthcare actuarial analyses
ASA or FSA designation required
Deep experience with Medicare Advantage, MSSP/ACO REACH, and Medicaid value-based programs
Strong data skills with SAS and SQL; familiar with R and Python
Bachelor’s degree required; master’s preferred