Manager, Actuarial Services at Imagine Pediatrics

, Texas, United States -

Full Time

Start Date

Immediate

Expiry Date

10 Jul, 26

Salary

180000.0

Posted On

11 Apr, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Actuarial science, Value-based care, Medicaid managed care, SQL, Financial modeling, IBNR estimation, Healthcare economics, Data analytics, Risk scoring, Strategic planning, Leadership, Communication, Problem-solving, Project management, Business acumen

Industry

Hospitals and Health Care

Description

Who We Are Imagine Pediatrics is a tech enabled, pediatrician led medical group reimagining care for children with special health care needs. We deliver 24/7 virtual first and in home medical, behavioral, and social care, working alongside families, providers, and health plans to break down barriers to quality care. We do not replace existing care teams; we enhance them, providing an extra layer of support with compassion, creativity, and an unwavering commitment to children with medical complexity. What You’ll Do As Manager, Actuarial Services you will combine your management capabilities and actuarial expertise to lead an actuarial team to conduct and present analytics on several business-critical initiatives. This position will be instrumental in supporting a value-based care business model for the pediatric Medicaid population. Key projects will include value-based care savings calculations, monthly close processes, development and application of IBNR estimates, and reporting/presenting financial and clinical results drivers that Imagine Pediatrics brings to its current and prospective member base and payer clients. Primary functions and responsibilities of this role will include but are not limited to: Manage and develop the processes and internal capabilities necessary to measure performance of value-based / shared savings arrangements and communicate valuable insights to key stakeholders. Manage monthly development and application of IBNR estimates. Partner with the Healthcare Economics (claims data analytics) team to demonstrate value our clients achieve with Imagine through the reporting of revenue / risk score trends, healthcare utilization trends, and financial savings. Analyze profitability by duration, acuity, and resource allocation to inform strategic recommendations to senior leadership. Work closely with other finance teams to monitor performance against forecasts, analyzing and explaining drivers of variances from revenue, cost, and membership. Prepare analyses for shared savings settlement discussions with payer partners. What You Bring & How You Qualify First and foremost, you’re passionate and committed to reimagining pediatric health care and creating a world where every child with complex medical conditions gets the care and support they deserve. Associate or Fellow of the Society of Actuaries Bachelor’s degree Minimum of 5 years of health actuarial experience, experience with value-based reimbursement strategies and affordability initiatives preferred Minimum of 2 years of Medicaid managed care experience Experience negotiating Medicaid managed care capitation rates is strongly preferred Prior leadership experience is preferred but not required Ability and willingness to train and transfer knowledge to junior level staff Actuarial knowledge of best practices for evaluation, modeling (cost, risk score and revenue) and analytics Strong SQL skills Ability to work effectively in a dynamic and fast-paced environment Strong communicator (both written and verbal) with an ability to break down complex and technical concepts in an easy-to-understand way Strong organizational, documentation and problem-solving skills Strong business acumen and interpersonal skills What We Offer (Benefits + Perks) The role offers a base salary range of $150,000 - $180,000 in addition to an annual bonus incentive, competitive company benefits package and eligibility to participate in an employee equity purchase program (as applicable). When determining compensation, we analyze and carefully consider several factors including job-related knowledge, skills and experience. These considerations may cause your compensation to vary. We provide these additional benefits and perks: Competitive medical, dental, and vision insurance Healthcare and Dependent Care FSA; Company-funded HSA 401(k) with 4% match, vested 100% from day one Employer-paid short and long-term disability Life insurance at 1x annual salary 20 days PTO + 10 Company Holidays & 2 Floating Holidays Paid new parent leave Additional benefits to be detailed in offer What We Live By We’re guided by our five core values: Our Values: Children First. We put the best interests of children above all. We know that the right decision is always the one that creates more safe days at home for the children we serve today and in the future. Earn Trust. We listen first, speak second. We build lasting relationships by creating shared understanding and consistently following through on our commitments. Innovate Today. We believe that small improvements lead to big impact. We stay curious by asking questions and leveraging new ideas to learn and scale. Embrace Humanity. We lead with empathy and authenticity, presuming competence and good intentions. When we stumble, we use the opportunity to grow and understand how we can improve. One Team, Diverse Perspectives. We actively seek a range of viewpoints to achieve better outcomes. Even when we see things differently, we stay aligned on our shared mission and support one another to move forward — together. We Value Diversity, Equity, Inclusion and Belonging We believe that creating a world where every child with complex medical conditions gets the care and support, they deserve requires a diverse team with diverse perspectives. We're proud to be an equal opportunity employer. People seeking employment at Imagine Pediatrics 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.

Responsibilities

The Manager of Actuarial Services will lead a team to conduct analytics on business-critical initiatives, specifically focusing on value-based care and Medicaid managed care. Responsibilities include managing IBNR estimates, reporting financial and clinical results, and partnering with the Healthcare Economics team to drive strategic recommendations.