Head of Actuary
Remote
Posted on 2/13/2024
One Medical

1,001-5,000 employees

Accessible, affordable healthcare through technology and primary care
Company Overview
One Medical sets itself apart by combining people-centered design and technology to deliver high-quality, affordable healthcare, challenging the traditional healthcare model. Their approach allows primary care providers to make informed decisions, leading to improved health outcomes and patient satisfaction. Moreover, their seamless integration of services saves patients both time and money, demonstrating their industry leadership in creating a more accessible healthcare system.

Company Stage

N/A

Total Funding

$4.3B

Founded

2007

Headquarters

San Francisco, California

Growth & Insights
Headcount

6 month growth

0%

1 year growth

1%

2 year growth

14%
Locations
San Francisco, CA, USA
Experience Level
Entry
Junior
Mid
Senior
Expert
Desired Skills
Power BI
Python
R
SQL
Tableau
Looker
Data Analysis
Snowflake
CategoriesNew
Business & Strategy
Data & Analytics
Requirements
  • 10+ years of experience in healthcare finance, consulting, or healthcare actuarial analytics
  • 3+ years of experience in Medicare/Medicare Advantage along with value based care
  • 3+ years of experience in health economics analysis and reporting
  • ASA required, FSA/MAAA Preferred
  • 3+ years experience in determining monthly TME estimates and risk adjustment evaluation preferred
  • Bachelor's Degree in Finance, Actuarial Science, Mathematics, Economics, or Business required
Responsibilities
  • Analysis of Medicare Advantage and Accountable Care Organization data primarily
  • Medical economics reporting and ad-hoc analysis relating to cost of care management
  • Medicare Risk score projections and Premium estimation
  • Design and implement an actuarially sound monthly reserving process for Total Medical Expense (TME) estimation
  • Lead continuous evaluation of TME performance compared to plan expectations
  • Managing an existing team of high performing actuaries with opportunity to grow the department as business needs expand
  • Coordinate with the finance team on future TME projections that are refreshed monthly and provided quarterly for forecasting and planning
  • Support month end financial and accounting processes for relevant actuarial estimates
  • Value based care contracting support and ongoing financial and risk analysis
  • Support ongoing actuarial support for outside auditor review of financial estimates and results
  • Design studies to monitor the suitability of the completion factor estimates
  • Lead continuous evaluation of risk based funding and scoring performance compared to plan expectations
  • Complete the evaluation of stop loss coverage and manage third party vendors
  • Analyze and develop new to market assessments and modeling which includes future Medicare geographic expansion and enhancements / changes to other market segments (Commercial potentially)
Desired Qualifications
  • Experience in the annual Medicare Advantage bid development process
  • Experience with ACO REACH or other new product offerings
  • Experience working in a fast paced environment, work with and understand effectively the attributes of current data
  • Experience with being part of improving and enhancing future use, retrieval, and analysis of improved data
  • Ability to work cross functionally with stakeholders (Operations, Finance, Planning, & Accounting (FP&A), Clinical, etc.) across the organization
  • Ability to lead, manage, and conduct multiple types of technical and actuarial analyses (e.g., pricing, reserving, and funding)
  • Strong technical programming skills; SQL, R, SAS, Python, Snowflake, Tableau/Looker
  • Demonstrated data visualization experience; Tableau/Looker, Power BI
  • Ability to work collaboratively to drive challenging and ambiguous projects
  • Ability to lead and grow actuarial team