Actuarial - Healthcare Economist

Florida Cancer Specialists•Florida - Remote, FL

2d•Remote

About The Position

The Actuarial – Healthcare Economist performs actuarial analysis pertinent to FCS businesses, including the Value-Based Care Program Portfolio and the analysis and supportive development of new alternative payment models and population health management. This individual should be proficient in actuarial science methodologies and develop / use relevant tools, databases, and record systems to gather and synthesize information for interpretation. The Actuarial – Healthcare Economist will provide detailed analysis, build forecasting models, consult with business leaders, and provide advice and recommendations for risk assessment and mitigation efforts across business units. They will assess affordability analytics in support of medical cost reduction, quality of care improvement, and increase in high-value care delivery and patient satisfaction. Additionally, they will prepare projections for market trends and relevant impacts to VBC programs using healthcare economics techniques and methods. This individual may also oversee actuarial or underwriting staff.

Requirements

Bachelor’s degree (B.A.) in actuarial science, healthcare economics, quantitative analysis, mathematics, or a closely related field; statistics background would prove helpful in this role.
Experienced healthcare economist or actuary, preferably with a large-scale payer or equivalent solution provider.
Experience with healthcare actual and underwriting functions required to successful meet the needs of understanding organizational risk.
Proficiency in database querying tools and strong data management skills.
Strong understanding of data systems and sources and how it impacts the data available.
Working knowledge of medical claims, billing practices, and health insurance requirements
Experience in building forecasting models and conducting budget impact analysis
Knowledge of actuarial landscapes of payers, the value metrics they use, principal calculation methods
Analysis & Critical Thinking; using resources available to solve problems and research solutions independently
Strong interpersonal skills to include effective verbal and written communication
Solid time management with the ability to prioritize multiple tasks
Must have strong organizational skills to prioritize tasks independently and track performance, communications, and outreaches to assigned territory
Ability to collaborate across various levels of management, departments, and teams
Must be comfortable with providing timely feedback in remote and in-person setting to physician and operational leadership clientele
Comfortable negotiating problems and exploring solutions with physician, upper management, and FCS leadership

Nice To Haves

Master’s degree in healthcare economics, Actuarial Science, Economics, analytics, or related field preferred.
ASA of FSA designation with ability to sign pricing and reserving opinions a plus.

Responsibilities

Maintain working knowledge of current value-based care contracts, programs, and initiatives
Collaborate with cross-functional teams to develop and implement value-based care models, payment structures, and reimbursement mechanism that’s align with incentives with improved patient outcomes / high value care.
Conduct in-depth analysis of healthcare data, claims utilization patterns, and cost trends to inform the development of actuarial models and economic forecasts.
Provide expert guidance on healthcare policy implications, regulatory changes, and market trends that may impact value-based care strategies.
Work closely with data scientists and healthcare professionals to design and refine models for risk adjustment, cost-sharing, performance measures.
Collaborate with internal and external stakeholders to communicate complex findings in a clear and concise manner, including presentations, reports, and recommendations.
Assess the financial impact of proposed value-based care programs, utilizing actuarial methodologies and economic principles to forecast potential incentives and risks.
Develop detailed analysis, build forecasting models, and trend analysis to present to key leaders and decision makers.