Providence Health & Services Portland , OR 97228
Posted 7 days ago
Providence Health Plan caregivers are not simply valued - they're invaluable. Join our team and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.
Providence Health Plan is calling a Manager Actuarial Analytics who will:
Lead the review of Medicaid capitation rate assumptions and methodology
Provide oversight to financial/encounter data submission in support of Medicaid capitation rate setting
Provide expertise and consultation to support the Medicare bid process and pricing strategy
Evaluate the financial performance for Medicaid/Medicare lines of business
Maintain an understanding of the changing health care trends and actuarial regulations and how they impact the organization
Remain current on government regulation and guidance as well as analytic techniques and methodologies, data sources
Build and maintain relationships with other leaders across the organization including Product, Finance, Regulatory, Pharmacy, and outside the organization (CMS, provider groups)
Coach and set priorities for direct reports
Please note the following important detail regarding this role:
Providence welcomes 100% remote work for residents who reside in the following States:
Washington
Oregon
California
Required qualifications for this position include:
Bachelor's Degree in Statistics, Computer Science, Mathematics, Social Science or another related field of study
5+ years of healthcare actuarial experience; Experience working with Medicare Advantage pricing and bid development
Experience with writing queries in SQL or another programming language
Demonstrated experience applying project management skills in data-related and financial analysis projects
Preferred qualifications for this position include:
Master's Degree in Statistics, Computer Science, Mathematics, Social Science or another related field of study
Fellow or Associate in the Society of Actuaries (FSA or ASA)
Experience certifying the Medicare Advantage Bid
Experience with Commercial, Medicare, and Medicaid revenue methodologies
Demonstrated experience with managing professional staff who work independently on tasks and projects
Why Join Providence Health Plan?
Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.
Providence Health & Services