How will this role have an impact?

Signify Health, a CVS Health company, is seeking a highly motivated and talented actuary to join our fast-growing organization. The actuary will be a key person on the Signify Intelligence team that analyzes various sources of patient health and claims data to help the business better understand, forecast and manage the risk position of various value-based products. The successful candidate will have strong knowledge of and experience in working with large Medicare claims dataset, conducting actuarial and risk adjustment (CMS-HCC) analysis.

What will you do?

• Evaluate the impact of Medicare quality and risk adjustment program has on our MA risk contracts and ACOs, including but not limited to risk adjustment opportunities, HCC gaps, and population comparison.
• Build models to help Signify identify areas to improve utilization of healthcare
• Assist with model development for identifying and implementing clinically viable tools and initiatives for provider behavior change
• Conduct descriptive and predictive analyses to identify opportunities to target population health interventions, improve care delivery, contribute to product and services development, and inform Signify Health’s growth strategy
• Analyze various sources of patient care and claims data, including 100% Medicare data or VRDC, to provide actionable insights to stakeholders
• Get up to speed on our data model and make recommendations for changes to improve the accuracy and efficiency of the monthly claims completion process
• Proactively identify and communicate issues affecting a project plan
• Prepare comprehensive documented observations, analyses and interpretations of results including technical reports, summaries and quantitative analyses
• Present analysis results to internal and external audiences, including company executives, subject matter experts, delivery teams, and clinical teams within Signify Health

We are looking for someone with:

• Bachelor’s Degree or higher in Mathematics, Statistics, Actuarial Science or closely related field
• 3-6 years of relevant industry experience
• Passed 4+ SOA exams, or attainment of ASA
• Deep knowledge of the CMS HCC Risk Adjustment program and the impact on Medicare Advantage plan performance
• Experience working with medical claims data and building utilization models
• Experience working on Medicare Advantage products at an insurance company or via consulting
• Strong SQL, SAS, Python, or R skills, ability to perform effective querying involving multiple tables and subqueries.

About Us:
Signify Health is helping build the healthcare system we all want to experience by transforming the home into the healthcare hub. We coordinate care holistically across individuals’ clinical, social, and behavioral needs so they can enjoy more healthy days at home. By building strong connections to primary care providers and community resources, we’re able to close critical care and social gaps, as well as manage risk for individuals who need help the most. This leads to better outcomes and a better experience for everyone involved.
Our high-performance networks are powered by more than 9,000 mobile doctors and nurses covering every county in the U.S., 3,500 healthcare providers and facilities in value-based arrangements, and hundreds of community-based organizations. Signify’s intelligent technology and decision-support services enable these resources to radically simplify care coordination for more than 1.5 million individuals each year while helping payers and providers more effectively implement value-based care programs.
To learn more about how we’re driving outcomes and making healthcare work better, please visit us at www.signifyhealth.com.

Diversity and Inclusion are core values at Signify Health, and fostering a workplace culture reflective of that is critical to our continued success as an organization.

We are committed to equal employment opportunities for employees and job applicants in compliance with applicable law and to an environment where employees are valued for their differences.