Director of Medical Economics and Actuarial - Remote

Overview

The Director of Medical Economics and Actuarial at Gather Health will lead the development and management of actuarial models to support financial processes and insights in a healthcare organization focused on value-based care for older adults.

In Short

• Design and manage reserve and IBNR models.
• Build medical expense projection models for budgets and forecasts.
• Enhance revenue forecasting accuracy using Medicare Advantage and Medicaid methodologies.
• Analyze healthcare cost drivers and trends.
• Deliver actionable insights from complex datasets.
• Collaborate with data teams and third-party actuarial partners.
• Inform contract negotiations with financial insights.
• Contribute to special projects and professional development.
• Communicate findings clearly for strategic decision-making.
• Shape the actuarial function's direction aligned with business goals.

Requirements

• Bachelor's degree in a relevant field.
• Associate of the Society of Actuaries (ASA) designation.
• Strong background in Medicare Advantage and CMS HCC modeling.
• Advanced Excel skills, including PivotTables and Power BI.
• Proficiency in SQL and large datasets.
• Experience in statistical product trend analyses.

Benefits

• Market-based base salaries.
• Unlimited/Self-Managed PTO.
• 11 Paid Holidays.
• Medical insurance coverage with no waiting period.
• Short and Long-Term disability insurance at no cost.
• 401K with a $1 for $1 match up to 4% of income.
• Employee Assistance Program at no cost.
• Supplemental benefits available.