The Chief Actuary leads actuarial functions including forecasting, reserving, and contracting for Aledade, mentoring teams and influencing health partnerships.
The Chief Actuary at Aledade is a key leadership position responsible for leading the actuarial function at Aledade. There are three primary functions, and two secondary activities. The primary functions are: (1). Forecasting. Looking across all of Aledade’s business, predict revenue and costs at various timescales, and build statistical models to determine how variable this forecast is. (2). Reserving. Working closely with our Strategic Payer Partnership and Finance teams, develop a strategy for Aledade to satisfy financial reserve / letters of credit requirements from health plans and lead actuarial negotiations. (3). Contracting. Develop the actuarial machinery to evaluate the financial terms of contracts with health plans, including assessing the financial risk and the impact that this contract will have on our reserving requirements.
There are two secondary functions: (a). Benchmarking / market intelligence. Understand actuarial trends of Aledade peer companies, health plans, and other relevant market participants. Translate those trends into (i) assumptions that feed the short and long-run forecasts and that inform resource planning and (ii) implications to inform Aledade’s operations. (b). Medical Economics Unit. Build the capacity to understand the key drivers of costs in Aledade’s “at risk” population and formally track efforts at Aledade to impact those trends, which impacts forecasting.
As a senior leader at Aledade, the Chief Actuary will actively promote a culture that aligns with Aledade and team values, and will coach and mentor other team members - both within Analytics and the broader company.
We are flexible with respect to geographic location in the United States, and the ideal candidate will be comfortable working remotely in the United States with considerable amounts of travel.
Primary Duties:
- Provide visionary leadership for and management of the actuary team, including forming close partnerships with the six main teams (Strategy Payer Partners, Finance, Performance, Policy, Aledade+, and the other parts of Analytics) to support other duties.
- Lead Aledade’s Forecasting efforts, including working with Finance, Performance, Policy and other Analytics teams. Actuary team will lead the “future years forecasting” (with support from Performance and Finance). Actuary team will support Performance (and Finance) teams for the “within year” forecast.
- Lead the Reserving strategy and operations, including actuarial renegotiations with health plans, as needed, including performing the analysis underlying these negotiations. Recommend to CFO the least costly way to meet these reserve requirements, given health plan requirements and the financial forecast.
- Lead the analytics to support the company’s Contracting function, as described above. Will support the Strategic Payer Partnership team, which leads payer contracting. Under the overall guidance of the Strategic Payer Partnership team, the chief actuary will model different potential contract terms, advise the Strategic Payer Partnership team on overall negotiations, and lead actuarial negotiations with health plans. Once a contract is signed, the chief actuary and their team will lead actuarial negotiations with health plans during the reconciliation process.
- Lead the Benchmarking / market intelligence function, including translating market trends into actionable business insights.
- Create the Medical Economics Unit, including thinking carefully about how to use existing resources in Finance, Analytics, and Aledade+ to support the goals of the Medical Economics Unit. Two examples: (i) Understanding and projecting the impact of new prescription drug classes on Medicare Advantage spending. (ii) Imagine Aledade is scaling a pilot across its full population, the chief actuary will be responsible for projecting the pilot results across Aledade’s patient population. Finally, the Medical Economics Unit could play a key role in explaining Aledade’s performance to investors.
Minimum Qualifications:
- Proven experience as an actuarial leader in a healthcare setting, with a proven record of leading and motivating actuarial teams and 15+ years of relevant education + work experience.
- Deep familiarity with government healthcare programs and policies, particularly Medicare, Medicare Advantage, Medicaid, and the Affordable Care Act.
- Exceptional ability to communicate (oral, written) complex actuarial concepts and engage with various stakeholders, including health plan partners, other leaders at Aledade, and potential investors.
- Experience leading negotiations for multi-million dollar contracts.
- A strong record of collaboration at the executive level with other leaders, including working with colleagues on complicated, multi-group initiatives.
- Strong quantitative skills, including experience with statistical analysis and predictive modeling in healthcare contexts. Deep experience with Excel, Tableau, and other similar tools.
- Fellowship-Level Certification from the Society of Actuaries, or other similar credential.
- Experience leading actuarial or similar function at an organization that is “at risk” for the cost of medical care, such as an “at risk” provider system, payer, or contractor.
Preferred Knowledge, Skills and/or Abilities:
- Data manipulation skills, including working knowledge of SQL, R, and/or SAS programming.
- Relevant experience leading teams performing some or all of the key duties, listed above (forecasting, reserving, contracting, benchmarking, and creating the medical economics unit).
- Experience with healthcare data (e.g. claims, EHR, clinical).
- Experience analyzing data and communicating results in data visualizations, dashboards, and reports for a wide variety of audiences (company/ACO executives, internal staff, physicians, etc.).
- Passionate about driving the shift from fee-for-service to value-based care.
Who We Are:
Aledade, a public benefit corporation, exists to empower the most transformational part of our health care landscape - independent primary care. We were founded in 2014, and since then, we've become the largest network of independent primary care in the country - helping practices, health centers and clinics deliver better care to their patients and thrive in value-based care. Additionally, by creating value-based contracts across a wide variety of health plans, we aim to flip the script on the traditional fee-for-service model. Our work strengthens continuity of care, aligns incentives and ensures primary care physicians are paid for what they do best - keeping patients healthy. If you want to help create a health care system that is good for patients, good for practices and good for society - and if you're eager to join a collaborative, inclusive and remote-first culture - you've come to the right place.
What Does This Mean for You?
At Aledade, you will be part of a creative culture that is driven by a passion for tackling complex issues with respect, open-mindedness and a desire to learn. You will collaborate with team members who bring a wide range of experiences, interests, backgrounds, beliefs and achievements to their work - and who are all united by a shared passion for public health and a commitment to the Aledade mission.
In addition to time off to support work-life balance and enjoyment, we offer the following comprehensive benefits package designed for the overall well-being of our team members:
Flexible work schedules and the ability to work remotely are available for many roles
Health, dental and vision insurance paid up to 80% for employees, dependents and domestic partners
Robust time-off plan (21 days of PTO in your first year)
Two paid volunteer days and 11 paid holidays
12 weeks paid parental leave for all new parents
Six weeks paid sabbatical after six years of service
Educational Assistant Program and Clinical Employee Reimbursement Program
401(k) with up to 4% match
Stock options
And much more!
At Aledade, we don’t just accept differences, we celebrate them! We strive to attract, develop and retain highly qualified individuals representing the diverse communities where we live and work. Aledade is committed to creating a diverse environment and is proud to be an equal opportunity employer. Employment policies and decisions at Aledade are based on merit, qualifications, performance and business needs. All qualified candidates will receive consideration for employment without regard to age, race, color, national origin, gender (including pregnancy, childbirth or medical conditions related to pregnancy or childbirth), gender identity or expression, religion, physical or mental disability, medical condition, legally protected genetic information, marital status, veteran status, or sexual orientation.
Privacy Policy: By applying for this job, you agree to Aledade's Applicant Privacy Policy available at https://www.aledade.com/privacy-policy-applicants
Top Skills
Excel
R
SAS
SQL
Tableau
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