AVP, Managed Care Contracting & Medical Economics
New
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TriEdge InvestmentsHealthcare
Remote, USAFull-TimeSenior
Salary150,000 - 200,000 USD per year
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Job Details
- Required Skills
- Microsoft ExcelPowerPoint
Requirements
- Bachelor’s degree (B.A.) in actuarial science, healthcare economics, quantitative analysis, mathematics, or a closely related field.
- ASA or FSA designation required, or significant progress towards such designations.
- Experience as a healthcare economist or actuary with a payor or benefits consultant background.
- Experience in client-facing roles.
- Strong proficiency with database tools to query, interpret, and build sensitivity models.
- Strong analytical abilities and proficiency with Microsoft Office, specifically Word, Excel, and PowerPoint.
- Demonstrated experience across different health insurance products such as Medicare, Medicaid, commercial, and exchange lines of business.
Responsibilities
- Apply quantitative analysis to underwrite risk across various value-based care contracts, including P4Q, professional fee capitation, and global capitation arrangements.
- Utilize healthcare terminology, including medical coding, claims data, and medical economic trends across Part A, B, and D segments.
- Query databases to interpret and build sensitivity models for evaluating risk propensity.
- Develop IBNR models using claims data to predict future paid claims experience.
- Collaborate with internal stakeholders on legal implications, financial forecasting, and operational delivery tactics.
- Engage with physicians, executive management, and external stakeholders through effective verbal and written communication.
- Participate in payor joint operating committee (JOC) meetings to facilitate alignment on performance targets.
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