Senior Director (Actuary)

The Senior Director - Actuary collaborates with stakeholders from across the organization and leads a team of directors and/or analysts to develop sophisticated risk management analytics that provide information, insights, and BI (Business Intelligence) solutions that contribute to sound strategic planning, risk assessment, decision-making, goal setting, and effective performance measurement. The Senior Director - Actuary will be a leader in the Managed Care and Population Health Analytics organizations and display a focus on the broad mission of MSHP to improve healthcare for our patients and providers in a financially sustainable manner.

•    Partner with stakeholders from Managed Care and/or Population Health departments who will look to your expertise related to evaluating existing value-based contracts as well as assessing new value-based contract and partnership opportunities. 
•    Partner closely with finance to support contract negotiations, contracting reconciliations/settlements, financial modeling, forecasting and cost trend analyses of Managed Care and/or Population Health contracts, including the impact of clinical interventions on total cost of care.
•    Develop medical economics-based reporting to identify opportunities to reduce the total cost of care for populations in our value-based contracts.
•    Support annual strategic planning, budgeting, and business case development.
•    Evaluate ongoing changes in payer contracts and government programs and make recommendations on appropriate actions for Mount Sinai.
•    Stay abreast of industry trends and changes in healthcare regulations to inform strategic decision-making.
•    Help develop staff to better understand population health, specialized risk arrangements, forecasting, financial modeling and performing analysis to inform business decisions. 
•    Analyze issues using enrollment, claims, clinical/EHR, medical management, financial and other corporate data from both modeled internal data as well as disparate internal and external sources. Also, help staff develop better analysis skills, understanding use cases and their value to the organization.
•    Leverage advanced statistical analysis methods to create insightful recommendations and conclusions that you effectively communicate to your stakeholders.
•    Clearly communicate data issues to the recipients and work to improve data quality where possible within the analytical models you create. Feed data quality issues back to IT or identified data stewards to assist in our quest for higher quality data.
•    Develop and present reports, analyses and findings to senior management and others as scheduled or requested.
•    Effectively communicates with stakeholders and customers and ensures all requests are properly triaged, recorded and tracked.
•    Adheres to corporate standards for performance metrics, data collection, data integrity, query design, and reporting format to ensure high quality, meaningful analytic output.
•    Develops and maintains project work plans, including critical tasks, milestones, timelines, interdependencies, and contingencies.  Tracks and reports progress.  Keeps stakeholders apprised of project status and implications for completion.
•    Prepares clear, well-organized project-specific documentation, including, at a minimum, analytic methods used, key decision points and caveats, with sufficient detail to support comprehension and replication.
•    Shares development and process knowledge with other managers and analysts to assure redundancy and continuously builds a core of analytical strength within the organization.
•    Maintain Actuarial certification(s)
 

• ASA/FSA Actuarial certification
• Bachelor’s degree in Actuarial Science, Math/Statistics, Economics, Finance, Computer Science or a related discipline; Masters or higher preferred

Experience Requirements

•    At least ten (10) years of experience at a health plan, health provider, accountable care organization or in actuarial consulting required.
•    FSA, PhD, MD or DO designation may be substituted for three (3) years of experience.
•    Strong analytical skills, with the ability to perform complex analyses and modeling using a wide variety of statistical methods in support of standard actuarial analyses (forecasting, pricing, reserving, funding).
•    At least three (3) years of experience in Medicare/Medicare Advantage and value-based care agreements with payers and/or employers.
•    At least three (3) years of experience with medical economics analyses, including utilization and unit cost analyses of medical and pharmacy claims.
•    At least three (3) years of experience with risk models, such as CMS HCC, Johns Hopkins ACG or other related products.
•    At least three (3) years of experience formally or informally leading a team of actuaries or other d