VBC Actuary

Duly Health and CareDowners Grove, IL
6d$107,000 - $160,000Onsite

About The Position

Good enough isn’t for us. Duly Health and Care’s team members show up every day driven to exceed expectations. We see and support the remarkable in every person within and beyond the walls of our work. Duly Health and Care works to understand what matters most to you. We recruit and retain team members who share a relentless passion and pride for helping others live happier and healthier lives. We invest in helping our team members develop their talents in a way that is rich in personal meaning. We invite you to join us, fulfill your purpose and make your mark! Holistic benefits designed to help our team members flourish in all aspects of their lives, including: Comprehensive medical, dental, and vision benefits that include healthcare navigation assistance and medical coverage at 100% (after deductible) when utilizing a Duly provider. Employer provided life and disability insurance. $5,250 Tuition Reimbursement per year. Immediate 401(k) match. 40 hours paid volunteer time off. A culture committed to community engagement and social impact. Up to 12 weeks parental leave at 100% pay and a financial benefit for adoption and surrogacy for non-physician team members once eligibility requirements are met.

Requirements

  • Associate of the Society of Actuaries (ASA)
  • Member of the American Academy of Actuaries (MAAA)
  • BS or BA in Actuarial Science, Mathematics, Statistics, Economics, or a related area
  • Minimum of five years of US healthcare actuarial work experience in managed care or closely related field, with at least 2 years estimating IBNR claims
  • Experience supporting the monthly IBNR process (preferably 3+ years)
  • Experience developing and maintaining complicated EXCEL/VBA models and presenting results (preferably 7+ years)
  • Knowledge of IBNR methodologies and concepts
  • Strong understanding of the US healthcare system
  • Ability to work effectively with other team members, auditors, payor contacts, and third-party actuaries
  • Ability to communicate complex concepts to technical and non-technical audiences
  • Understanding of financial statements
  • Understanding of relational databases
  • Understanding of medical and pharmacy trends
  • Understanding of medical claims coding and categorization
  • Advanced knowledge of Excel
  • Knowledge of SQL/Databricks

Nice To Haves

  • Ability to write and edit VBA macros preferred
  • Ability to identify and drill down into causes of changes in medical expenses

Responsibilities

  • Performance and maintenance of the monthly incurred but not reported (IBNR) healthcare claims process for a large risk based multi-specialty value-based care organization. Serve as a subject matter expert on IBNR estimates and payor data files. Investigate and analyze utilization and medical cost data in support of financial close, budget, and forecasting processes.
  • Create the monthly claim triangles, populate the IBNR models, and produce the IBNR estimates, working closely with accounting, finance, and operational leaders. Communicate results and supporting information to internal audiences including Finance, Accounting, and Value Based Care executives and team members. Maintain the IBNR models. Research issues and trends and keep leaders informed of findings. Update related monthly reports. Act as key contributor and subject matter expert during budget and forecast cycles. Interact with payor contacts and third-party actuaries as appropriate. (70%)
  • Support the annual financial statement audit. Prepare lookback analyses and other information as requested by the auditor. Meet with the auditor as needed to answer questions. (5%)
  • Perform medical expense projections and evaluate against payor contracts. (10%)
  • Perform ad hoc analyses as requested by management. Independently surface insights and recommendations that help improve the accuracy of IBNR models and/or value-based care operations. (15%)
  • Role is viewed as a primary subject matter expert on all matters related to IBNR and will be looked to for advice, guidance, and mentorship.
  • Manage entire IBNR process, on a monthly basis, to completion, meeting predetermined timelines.

Benefits

  • Comprehensive medical, dental, and vision benefits that include healthcare navigation assistance and medical coverage at 100% (after deductible) when utilizing a Duly provider.
  • Employer provided life and disability insurance.
  • $5,250 Tuition Reimbursement per year.
  • Immediate 401(k) match.
  • 40 hours paid volunteer time off.
  • A culture committed to community engagement and social impact.
  • Up to 12 weeks parental leave at 100% pay and a financial benefit for adoption and surrogacy for non-physician team members once eligibility requirements are met.

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What This Job Offers

Job Type

Full-time

Career Level

Mid Level

Number of Employees

5,001-10,000 employees

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