Head of Actuary (Remote)
One Medical is a primary care solution challenging the industry status quo by making quality care more affordable, accessible and enjoyable. But this isn’t your average doctor’s office. We’re on a mission to transform healthcare, which means improving the experience for everyone involved - from patients and providers to employers and health networks. Our seamless in-office and 24/7 virtual care services, on-site labs, and programs for preventive care, chronic care management, common illnesses and mental health concerns have been delighting people for the past fifteen years.
In February 2023 we marked a milestone when One Medical joined Amazon. Together, we look to deliver exceptional health care to more consumers, employers, care team members, and health networks to achieve better health outcomes. As we continue to grow and seek to impact more lives, we’re building a diverse, driven and empathetic team, while working hard to cultivate an environment where everyone can thrive.
One Medical is seeking our Head Actuary to join its Actuarial & Strategic Finance Team. This fast-paced role provides an outstanding opportunity to influence data-driven business decisions. The Actuarial & Strategic Finance team has exposure to all facets of the business and plays a critical role in shaping the future and strategy of the company through forecasting and analysis of key business drivers. This position will have the opportunity to work on non-traditional actuarial projects in a rapidly growing business environment.
You will partner directly with our finance and clinical team members to help build out our core actuarial functions and support strategic decisions. As an actuarial leader on the team you will own key processes across Total Medical Claims projections, forecasting, pricing, and value-based contract analytics. You will help design new processes that provide critical and timely evaluation of our financial risks to the strategic finance team. As organizational needs grow, you will have the ability to expand your scope as needed. This is a heavy hands on position while we prove out added value over the next 12 - 18 months.
We’d love to speak to you if you are extremely proactive, motivated, well-organized, and have the ability to multitask while working with different stakeholders within the organization.
What you'll work on:
- Analysis of Medicare Advantage and Accountable Care Organization data primarily.
- Medical economics reporting and ad-hoc analysis relating to cost of care management.
- Medicare Risk score projections and Premium estimation.
- Design and implement an actuarially sound monthly reserving process for Total Medical Expense (TME) estimation.
- Lead continuous evaluation of TME performance compared to plan expectations.
- Managing an existing team of high performing actuaries with opportunity to grow the department as business needs expand.
- Coordinate with the finance team on future TME projections that are refreshed monthly and provided quarterly for forecasting and planning.
- Support month end financial and accounting processes for relevant actuarial estimates.
- Value based care contracting support and ongoing financial and risk analysis.
- Support ongoing actuarial support for outside auditor review of financial estimates and results.
- Design studies to monitor the suitability of the completion factor estimates.
- Lead continuous evaluation of risk based funding and scoring performance compared to plan expectations.
- Complete the evaluation of stop loss coverage and manage third party vendors.
- Analyze and develop new to market assessments and modeling which includes future Medicare geographic expansion and enhancements / changes to other market segments (Commercial potentially).
What You’ll need:
- 10+ years of experience in healthcare finance, consulting, or healthcare actuarial analytics required.
- Must have 3+ years of experience in Medicare/Medicare Advantage along with value based care.
- Must have 3+ years of experience in health economics analysis and reporting.
- ASA required, FSA/MAAA Preferred.
- 3+ years experience in determining monthly TME estimates and risk adjustment evaluation preferred.
- Experience in the annual Medicare Advantage bid development process is a plus.
- Experience with ACO REACH or other new product offerings is a plus.
- Must have experience working in a fast paced environment, work with and understand effectively the attributes of current data.
- Experience with being part of improving and enhancing future use, retrieval, and analysis of improved data.
- Ability to work cross functionally with stakeholders (Operations, Finance, Planning, & Accounting (FP&A), Clinical, etc.) across the organization
- Ability to lead, manage, and conduct multiple types of technical and actuarial analyses (e.g., pricing, reserving, and funding)
- Strong technical programming skills; SQL, R, SAS, Python, Snowflake, Tableau/Looker,
- Demonstrated data visualization experience; Tableau/Looker, Power BI
- Ability to work collaboratively to drive challenging and ambiguous projects
- Ability to lead and grow actuarial team
- Bachelor's Degree in Finance, Actuarial Science, Mathematics, Economics, or Business required.
Benefits designed to aid your health and wellness:
Taking care of you today
- Paid sabbatical after 5 and 10 years
- Employee Assistance Program - Free confidential advice for team members who need help with stress, anxiety, financial planning, and legal issues
- Competitive Medical, Dental and Vision plans
- Free One Medical memberships for yourself, your friends and family
- Pre-Tax commuter benefits
- PTO cash outs - Option to cash out up to 40 accrued hours per year
Protecting your future for you and your family
- 401K match
- Opportunity to participate in company equity programs
- Credit towards emergency childcare
- Company paid maternity and paternity leave
- Paid Life Insurance - One Medical pays 100% of the cost of Basic Life Insurance
- Disability insurance - One Medical pays 100% of the cost of Short Term and Long Term Disability Insurance
This is a full-time role based anywhere in the US remotely
One Medical is an equal opportunity employer, and we encourage qualified applicants of every background, ability, and life experience to contact us about appropriate employment opportunities.
One Medical participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. Please refer to the E-Verification Poster (English/Spanish) and Right to Work Poster (English/Spanish) for additional information.