Director Actuary
Director Actuary
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$ 159939 - 191926
1 Vacancy
Job Description
WelbeHealth PACE (Program of AllInclusive Care for the Elderly) helps seniors stay in their homes and communities by providing allinclusive medical care and communitybased services. We serve our most vulnerable seniors with better quality and compassion in a valuebased model.
The Director Actuary is accountable for all actuarial functions related to PACE revenue claims modeling and financial analysis. This role will focus on overseeing capitation rates risk adjustment methodologies claims forecasting and Incurred But Not Reported (IBNR) reserves to guide the organizations strategic decisionmaking.
Essential Job Duties:
- Direct the development maintenance and enhancement of the PACE revenue model ensuring accurate accounting forecasting and financial planning
- Assess and refine riskadjusted revenue projections for MedicareMedicaid dualeligible populations incorporating CMS and state methodologies
- Own and enhance methodologies for claims projection IBNR estimation and actuarial reserve setting to ensure financial stability and regulatory compliance
- Monitor and interpret CMS state and Medicaid regulatory changes impacting reimbursement rates risk scores and capitation structures
- Oversee actuarial modeling claims analyses and risk assessments to improve costeffectiveness and reimbursement accuracy
- Work closely with finance underwriting product development and executive leadership to drive strategic initiatives
- Lead full scale actuarial projects and project teams as well as participate in any required Quality Improvement activities staff trainings and meetings
Job Requirements:
- Bachelors degree in actuarial science mathematics statistics finance or a related field required; ASA or FSA designation preferred
- Minimum of seven 7 years of actuarial experience with a strong background in Duals (MedicareMedicaid) or PACE revenue models highly preferred
- Two 2 years of supervisory experience with demonstrated ability managing teams and collaborating across departments to drive actuarial and financial initiatives preferred
- Excellent leadership organizational and communication skills in settings with seniors their families and interdisciplinary team members
- Proficiency in actuarial software (e.g. SAS SQL Python R) Excel and financial modeling tools
- Deep understanding of CMS risk adjustment Medicaid ratesetting and Medicare Advantage/Part D payment models
- Must be willing and able to work a varied schedule that may include evening nights weekends and overtime
Benefits of Working at WelbeHealth: Apply your actuarial expertise in new ways as we rapidly expand. You will have the opportunity to design the way we work in the context of an encouraging and loving environment where every person feels uniquely cared for.
- 401k employer match
- Medical insurance coverage (Medical Dental Vision) starting day one of employment
- Work life balance we mean it! 17 days of personal time off (PTO) 12 holidays observed annually sick time
- And additional benefits
Salary/Wage base range for this role is $159939 $191926/ year Bonus Equity. WelbeHealth offers competitive total rewards package that includes 401k match healthcare coverage and a broad range of other benefits. Actual pay will be adjusted based on experience and other qualifications.
Compensation
$159939 $191926 USD
COVID19 Vaccination Policy
At WelbeHealth our mission is to unlock the full potential of our vulnerable seniors. In this spirit please note that we have a vaccination policy for all our employees and proof of vaccination or a vaccine declination form will be required prior to employment. WelbeHealth maintains required infection control and PPE standards and has requirements relevant to all team members regarding vaccinations.
Our Commitment to Diversity Equity and Inclusion
At WelbeHealth we embrace and cherish the diversity of our team members and were committed to building a culture of inclusion and belonging. Were proud to be an equal opportunity employer. People seeking employment at WelbeHealth are considered without regard to race color religion sex gender gender identity gender expression sexual orientation marital or veteran status age national origin ancestry citizenship physical or mental disability medical condition genetic information or characteristics (or those of a family member) pregnancy or other status protected by applicable law.
Beware of Scams
Please ensure your application is being submitted through a WelbeHealth sponsored site only. Our emails will come from @welbehealth email addresses. You will never be asked to purchase your own employment equipment. You can report suspected scam activity to
Required Experience:
Director
Employment Type
Full-Time
