Manager, Value-Based Care Actuarial Analytics

A major health plan is seeking a credentialed actuary to lead financial analysis and strategy related to provider reimbursement and value-based care initiatives. This individual will be responsible for evaluating provider performance, developing financial forecasts, identifying cost-saving opportunities, and partnering with senior leadership to drive healthcare affordability and operational effectiveness.

This is a highly visible, fully remote leadership opportunity that combines actuarial analytics, healthcare economics, provider contracting, and strategic business decision-making.

Key Responsibilities:

Value-Based Care Strategy & Analytics

• Lead financial analysis supporting value-based provider arrangements and alternative payment models.
• Evaluate the performance of provider contracts and identify opportunities to improve cost, quality, and overall value.
• Develop actionable insights related to healthcare utilization, medical cost trends, and provider performance.
• Support the design and measurement of value-based reimbursement initiatives across multiple lines of business.

Financial Forecasting & Performance Monitoring

• Build and oversee financial models used to project provider contract performance and healthcare spending.
• Analyze key drivers of medical cost trends and provide recommendations to improve financial outcomes.
• Monitor performance against expectations, identify emerging risks, and communicate findings to leadership.
• Support long-term strategic planning through actuarial and economic analysis.

Leadership & Cross-Functional Collaboration

• Manage and mentor a small team of actuarial and analytical professionals.
• Partner closely with leadership teams across actuarial, network management, finance, clinical, and strategy functions.
• Translate complex analytical findings into actionable recommendations for executive stakeholders.
• Foster a collaborative, high-performing team culture focused on innovation and continuous improvement.

Qualifications:

• Bachelor's degree in Actuarial Science, Mathematics, Statistics, Economics, Finance, or a related field.
• ASA designation required; FSA preferred.
• 7+ years of health actuarial experience.
• Previous experience analyzing provider reimbursement arrangements, value-based care programs, or medical cost performance strongly preferred.
• Prior people management or team mentorship experience required.
• Strong understanding of healthcare economics, medical cost drivers, and health insurance financial performance.
• Experience building and presenting complex financial analyses to senior leadership.
• Excellent communication, project management, and stakeholder management skills.

Preferred Experience:

• Value-based care analytics.
• Provider contract financial modeling.
• Total cost of care analysis.
• Claims-based experience studies.
• Healthcare trend analysis and forecasting.
• Commercial and/or government-sponsored health programs.