Role Summary

HIGHLIGHTS

Director-level health actuarial and medical economics role focused on Medicaid value-based contracts across the US. You’ll own savings forecasts, IBNR and reserves, build underwriting frameworks, and lead medical economics and actuarial analytics. Reports to the Chief Revenue Officer (acting CFO) and combines hands-on modelling with building a scaled analytics function.

JOB DESCRIPTION SUMMARY

Lead financial forecasting, IBNR and reserves for Medicaid value-based contracts
Develop underwriting frameworks and monitor MLR- and RCT-based contract performance
Build tools, data infrastructure, and analytical exhibits to support partners
Work closely with health plan actuaries and present to senior stakeholders
Director role with team-building and leadership responsibilities

DOMAIN EXPERTISE

Medicaid managed care capitation and risk adjustment
Value-based care and shared savings contract financial forecasting
IBNR and reserve development for healthcare claims
Contract underwriting and MLR-based performance frameworks
Analysis of large, complex healthcare claims datasets

KEY REQUIREMENTS

10+ years in health actuarial science or medical economics
3–5 years in a leadership role
Deep Medicaid managed care expertise (capitation, risk adjustment, MLR)
Expert-level reserving, forecasting, and total cost-of-care modelling
Strong SQL and Python and/or R skills plus advanced Excel

TECH STACK

Excel
PowerPoint
Jupyter_Notebook

Role Summary

HIGHLIGHTS

JOB DESCRIPTION SUMMARY

Lead financial forecasting, IBNR and reserves for Medicaid value-based contracts
Develop underwriting frameworks and monitor MLR- and RCT-based contract performance
Build tools, data infrastructure, and analytical exhibits to support partners
Work closely with health plan actuaries and present to senior stakeholders
Director role with team-building and leadership responsibilities