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Centene

Runs government-backed health insurance plans

Actuary: Value-Based Care

Actuarial & Risk ModellingConfirmed live in the last 24 hours
Full-timeRemote in USA$107.7k - $199.3k /yr

About the Job

Requirements

  • At least 5 years of actuarial experience and Associate of the Society of Actuaries (ASA) certification, or at least 4 years of actuarial experience and Fellow of the Society of Actuaries (FSA) certification.
  • A bachelor's degree in a related field or equivalent experience is required.
  • Preferred technical skills include Excel, SQL, Teradata, and Snowflake.
  • Membership in the American Academy of Actuaries (MAAA) is preferred.
  • Experience in vendor arrangements, healthcare claims and revenue data, and trend analysis is desired.

Responsibilities

  • Conduct analysis, pricing, and risk assessment to estimate financial outcomes.
  • Support the Vendor Analytics Team in ensuring value-based care (VBC) contracts are actuarially sound and provide financial value.
  • 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 negotiations with external vendors, 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 knowledge of mathematics, probability, statistics, principles of finance, and business to calculate financial outcomes.
  • Perform other duties as assigned and comply with all policies and standards.

About the Company

Centene

Runs government-backed health insurance plans

Centene runs government-backed health insurance plans in the United States, with Medicaid as its largest business alongside Medicare and Affordable Care Act Marketplace coverage. It is one of the largest Medicaid insurers in the country and also runs plans for people eligible for both Medicare and Medicaid, long-term care and children in foster care. States and the federal government pay Centene a set amount per member to manage care, and individuals buy its Ambetter Marketplace plans, often with federal subsidies. Centene contracts with local doctors, hospitals and pharmacies and keeps the difference between premiums and the cost of care. The company was founded in 1984 in Milwaukee and is headquartered in Clayton, Missouri.

Company size
10,001+
Company stage
IPO
Headquarters
Clayton, MO
Founded
1984

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