Providence Health & Services Manager - Actuary Vbc in Oregon
Providence St. Joseph Health is calling a Manager - Actuary Vbc to work remotely within any of our footprint states: AK, CA, MT, NV, OR, TX and/or WA.
We are seeking a Manager - Actuary Vbc who will report to the Director, Value Based Care, the Actuarial Manager, Value Based Care, is a thought leader in developing, operationalizing, and maintaining financial models and analyses for tracking, reporting, and improving the performance of value-based care (VBC) and risk arrangements at the contract level, at the portfolio level, and at the regional/service area level. The Actuarial Manager has accountability for providing decision support for the VBC, Population Health Informatics team, and Medicare VBC team, including financial and comparative analyses and data requests to support PSJH participation in various alternative payment models (APMs) with CMS and private health plans, assuring long-term growth of Value Based Care within Providence St. Joseph Health (PSJH). The Actuarial Manager is responsible for serving as a liaison between Population Health division and System Finance for the purposes of accurately capturing, recognizing, and allocating PSJH VBC expected and earned incentives. This position will need to work within a complex organizational structure with minimal direction and in a manner that balances achievement of strategic and operational goals while maintaining effective relationships with other business divisions.
In this position you will have the following responsibilities:
Builds, performs, and maintains financial models and analyses for tracking, reporting, and improving the performance of value-based care (VBC) and risk arrangements at the contract level, at the portfolio level, and at the regional/service area level.
Provides financial analysis including performing complex reconciliations for VBC and risk arrangements. Models financial impacts of changes in risk adjustment, utilization management, and arrangement structure.
Conducts gap analysis and data validation, identifying possible issues in data submission and determining financial impact.
Supports VBC contracting efforts by calculating impact of changes to contract parameters and by developing new contract structures.
Analyzes data sets and utilizes statistical methodologies to predict future trends in cost, utilization, and performance. Provides executive summary of findings to requestors.
Serves as a liaison between Population Health division and System Finance for the purposes of accurately capturing, recognizing, and allocating PSJH VBC expected and earned incentives.
Provides decision support for the VBC and Population Health Informatics team, including financial and comparative analyses and data requests to support PSJH participation in various alternative payment models (APMs) with CMS and private health plans.
Conducts complex quantitative analyses using tools such as SQL, SAS, Access, and Excel.
Completes ad hoc analyses to support internal and external customers.
Exhibits initiative in exploring and discovering opportunities to PSJH performance in APMs through data analysis.
Presents analyses/reports in clear and useful format to system and regional leadership.
Supervises Financial Analysts, Sr. Financial Analysts, and Actuarial Analysts on the VBC team.
Acts independently to determine methods and procedures on new or special assignments for recommendation and implementation.
Required qualifications for this position include:
Bachelor's Degree in Finance, Mathematics, Statistics, Actuarial Science or related field.
Successful completion of the requirements of the Associate of the Society of Actuaries (ASA) designation.
6 years experience in financial reporting and analytics.
3 years experience working for a large health care provider or plan.
4 years leadership experience.
Extensive experience with advanced analytic features of Excel, Access and/or SQL.
Preferred qualifications for this position include:
- Master's Degree in Finance, Business Administration, Mathematics, Statistics, Actuarial Science or related field.
About the department you will serve.
Providence Shared Services provides a variety of functional and system support services for our Providence family of organizations across Alaska, California, Montana, New Mexico, Oregon, Texas and Washington. We are focused on supporting our Mission by delivering a robust foundation of services and sharing of specialized expertise.
We offer comprehensive, best-in-class benefits to our caregivers. For more information, visit
As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
Providence is a comprehensive not-for-profit network of hospitals, care centers, health plans, physicians, clinics, home health care and services continuing a more than 100-year tradition of serving the poor and vulnerable. Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression, sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.
Job Category: Non-Clinical Lead/Supervisor/Manager
Other Location(s): Montana, Nevada, California, Oregon, Washington, Texas, Alaska
Req ID: 313891