Actuary – Value-Based Care

Centene Corporation•Washington, NV

5d•$107,700 - $199,300•Remote

About The Position

Conduct analysis, pricing, and risk assessment to estimate financial outcomes and support the Vendor Analytics Team in ensuring value-based care (VBC) contracts are actuarially sound and provide financial value. The role develops financial models for VBC arrangements, analyzes savings opportunities and program and vendor value, and provides analytical support during external vendor negotiations. It partners with Medicare/Marketplace and Medicaid teams and offers varied work across lines of business, new analytical challenges, and opportunities to present findings to leadership. The position is fully remote within the continental United States.

Requirements

Bachelor's degree in a related field or equivalent experience.
Either 5 or more years of actuarial experience and Associate in the Society of Actuaries (ASA) certification, or 4 or more years of actuarial experience and Fellow in the Society of Actuaries (FSA) certification.
Experience with vendor arrangements, healthcare claims and revenue data, and trend analysis is sought in ideal candidates.
Strategic thinking skills.
Technical skills in Excel, SQL, Teradata, and Snowflake are preferred.

Nice To Haves

Member of the American Academy of Actuaries (MAAA).
Experience with vendor arrangements, healthcare claims and revenue data, and trend analysis.
Technical skills in Excel, SQL, Teradata, and Snowflake.

Responsibilities

Lead development of financial models to assess financial risk and opportunity associated with proposed and existing VBC arrangements, including shared savings and risk, capitation, bundled payments, and specialty carve-outs.
Analyze claims and vendor performance data to establish baselines, measure performance, and identify trends.
Provide analytical support and subject matter expertise during external vendor negotiations, including financial terms, risk structures, and analytical methodologies.
Communicate complex findings and recommendations to technical and non-technical audiences, including leadership.
Collaborate with internal teams to gather input, align on strategy, and ensure VBC strategies are analytically sound, operationally feasible, and aligned with enterprise goals.
Independently identify issues in vendor contracts and performance, develop analytical approaches, and drive solutions.
Work with Medicare/Marketplace and Medicaid teams to assess the impact of program and policy changes on trends and vendor contracts.
Research and identify new business opportunities.
Apply mathematics, probability, statistics, principles of finance, and business knowledge to calculate financial outcomes.
Perform other duties as assigned and comply with all policies and standards.