Actuary – VBC / Vendor Analytics
| Company | Centene |
|---|---|
| Location | New Mexico, USA, Washington, USA, Kansas, USA, Pennsylvania, USA, North Dakota, USA, Oregon, USA, Delaware, USA, Iowa, USA, California, USA, Washington, DC, USA, Vermont, USA, Wyoming, USA, Texas, USA, Montana, USA, Jackson Township, NJ, USA, Florida, USA, Waterbury, CT, USA, Nevada, USA, South Carolina, USA, South Dakota, USA, Georgia, USA, Arizona, USA, Concord, NH, USA, Mississippi, USA, Tennessee, USA, Virginia, USA, Minnesota, USA, Colorado, USA, Rhode Island, USA, Utah, USA, Northeastern United States, USA, Kentucky, USA, West Virginia, USA, New York, NY, USA, Maryland, USA, Wisconsin, USA, Maine, USA, Massachusetts, USA, North Carolina, USA, Oklahoma, USA, Missouri, USA, Ohio, USA, Louisiana, USA, Michigan, USA, Illinois, USA, United States, Idaho, USA |
| Salary | $Not Provided – $Not Provided |
| Type | Full-Time |
| Degrees | Bachelor’s |
| Experience Level | Senior |
Requirements
- Bachelor’s degree or in related field or equivalent experience
- 5+ years of actuarial experience
- Associate of the Society of Actuaries (ASA) (or equivalent international certification)
- Member of American Academy of Actuaries (or equivalent international membership)
Responsibilities
- Apply knowledge of mathematics, probability, statistics, principles of finance and business to design, model, financially engineer, and evaluate complex Value-Based Care (VBC) financial arrangements and associated vendor contracts
- Lead the development of sophisticated financial models to assess financial risk and opportunity associated with proposed and existing VBC arrangements (e.g., shared savings/risk, capitation, bundled payments, specialty carve-outs)
- Provide robust analytical support and subject matter expertise during negotiations with external vendors, defend analytical methodologies, and clearly articulate the company’s financial positions related to VBC arrangements
- Collaborate effectively with internal matrix partners (including, but not limited to, Medical Economics, Enterprise Partnerships, Network Management, Clinical Operations, Finance, and Data Analytics teams) to ensure VBC strategies are analytically sound, operationally feasible, and aligned with enterprise goals
Preferred Qualifications
- Minimum of 5+ years of experience in healthcare analytics, actuarial science, or data science within a health plan, managed care organization, provider system, or consulting firm
- Strong preference for hands-on experience in Value-Based Care (VBC) contract modeling, financial engineering, and analysis within a payer environment
- Familiarity with Medicare, Medicaid, and ACA programs within managed care settings is highly valued
- Advanced Excel modeling, strong SQL skills, and a solid understanding of healthcare data structures
- Experience with data visualization tools (e.g., Tableau, Power BI) and statistical programming languages such as R or Python is a plus
- Deep understanding of various VBC models (e.g., shared savings/risk, capitation, bundled payments), including baseline setting, risk adjustment, performance metrics, and reconciliation logic
- Proven ability to negotiate complex financial and analytical terms externally and communicate sophisticated concepts clearly to both technical and non-technical audiences