BHC Senior Actuarial Analyst

Bryan Health

  • Lincoln, NE
  • Permanent
  • Full-time
  • 1 month ago
GENERAL SUMMARY:Serves as the key population health analytics expert on the Bryan Health Connect (BHC) team. Partners with the Accountable Care Organization (ACO) and Physician Hospital Organization (PHO) teams to identify, measure, and communicate key performance indicators across all value-based contracts (VBC), direct-to-employer (DTE), and other related agreements. Develops standard reporting and methodology for prioritizing areas of risk and opportunities on a population of more than 100,000 beneficiaries and $500+ of claims expense and collaborates with leadership to develop team strategy and tactics.PRINCIPAL JOB FUNCTIONS:
  • *Commits to the mission, vision, beliefs and consistently demonstrates our core values.
  • *Creates tools, models and analyses using advanced statistical and/or actuarial methods.
  • *Maintains extremely high standards for preservation and replication of process and analytical outputs.
  • *Applies principals of continuous improvement to supported models and tools through enhancing techniques, enriching data and improving processes.
  • *Participates in and supports team workstream planning process.
  • *Works collaboratively with leaders and end-users to define business problems and appropriate solutions including project scoping and technical requirements.
  • Supports enterprise Data Governance process.
  • *Responsible for maintenance and reliability of supported analytics products.
  • Participates in vendor evaluations when assigned.
  • *Serves as the organization’s key quantitative expert on both fee-for-service and fee-for-value contracting.
  • *Develops analytics products and presentation materials needed to inform senior leadership, including decision recommendations.
  • Coaches and educates partners and leaders on key factors impacting contracting strategy and risk.
  • Connects operational initiatives to payor contracting through analysis.
  • Conducts ongoing or recurring work with minimal oversight.
  • Maintains professional growth and development through seminars, workshops, and professional affiliations to keep abreast of latest trends in field of expertise.
  • Participates in meetings, committees and department projects as assigned.
  • Performs other related projects and duties as assigned.
(Essential Job functions are marked with an asterisk “*.” Refer to the Job Description Guide for the definition of essential and non-essential job functions.) Attach Addendum for positions with slightly different roles or work-specific differences as needed.REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:
  • Expert knowledge of actuarial principals and applications.
  • Expert knowledge in health claims modeling, including benchmarking, risk-adjustment, IBNR calculation, and utilization trending.
  • Expert knowledge in payor contract structure, including fee-for-value and fee-for-service.
  • Expert ability in building actuarial analyses and reports.
  • Expert ability to effectively communicate insights and findings to leaders and end-users outside of analytics.
  • Expert ability at impact and root cause analysis in regard to claims trends and operational initiatives.
  • Broad knowledge of SQL and data sourcing.
  • Knowledge and awareness of healthcare applications, database structure, and common metrics.
  • Knowledge of basic data governance concepts and application (data quality, stewardship, etc.).
  • Knowledge of principals of probability, statistics, and advanced application and techniques.
  • Knowledge of computer hardware equipment and software applications relevant to work functions.
  • Skill in using R, Python or related method to construct and execute complex statistical models.
  • Ability to work as part of a team and individually.
  • Ability to prioritize work demands and work with minimal supervision.
  • Ability to problem solve and engage independent critical thinking skills.
  • Ability to communicate effectively both verbally and in writing.
  • Ability to adhere and adapt to current and future standards for deliverables.
  • Ability to maintain confidentiality relevant to sensitive information.
  • Ability to maintain regular and punctual attendance.
EDUCATION AND EXPERIENCE:Bachelor’s degree in mathematics, statistics, actuarial science, or closely related field required. Master’s degree is preferred. Five (5) years of experience in an actuarial or risk analyst role directly supporting contracts encompassing at least $500m in claims expense required. Prior healthcare experience is highly preferred. Associate of the Society of Actuaries (ASA) status as a chartered actuary is required. Prior Epic experience preferred.OTHER CREDENTIALS / CERTIFICATIONS:Three (3) or more exams passed through the Society of Actuaries preferred.PHYSICAL REQUIREMENTS:(Physical Requirements are based on federal criteria and assigned by Human Resources upon review of the Principal Job Functions.)(DOT) – Characterized as sedentary work requiring exertion up to 10 pounds of force occasionally and/or a negligible amount of force frequently to lift, carry, push, pull or otherwise move objects, including the human body.Sedentary work involves sitting most of the time but may involve walking or standing for brief periods.

Bryan Health