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Job Details

Actuarial Consultant - Medicare Lead

Requisition #: 283823
Location: Johns Hopkins Health Care, Hanover, MD 21076
Category: Finance
Work Shift: Day Shift
Work Week: Full Time (40 hours)
Weekend Work Required: No
Date Posted: Dec. 1, 2020

Johns Hopkins HealthCare (JHHC) is the managed care and health services business of Johns Hopkins Medicine, one of the premier health delivery, academic, and research institutions in the United States. JHHC is a $2.5B business serving over 400,000 lives with lines of business in Medicaid, Medicare, commercial, military health, health solutions, and venture investments. JHHC has become a leader in provider-sponsored health plans and is poised for future growth.

Many organizations talk about transforming the future of healthcare, Johns Hopkins HealthCare is actually doing it. We develop innovative, analytics-driven health programs in collaboration with provider partners to drive improved quality and better health outcomes for the members and communities we serve. If you are interested in improving how healthcare is delivered, join the JHHC team.

This position may have an option of being remote

This role reports through the Director of Actuarial service, which is part of the JHHC Health Economics & Actuarial Team (HEAT). HEAT is a division of the JHHC Finance department and is a center of financial analytic activity that range from valuing IBNR to developing claims projections and revenue forecasts & strategy to statistical analysis and financial modeling.

This role will help drive a significant portion of the Medicare Actuarial and Product design analytics at JHHC and has a primary focus of driving bid analytics and strategy. The Medicare Advantage line of business is an exciting and growing division of JHHC and this role will be very visible across the Medicare leadership team. The person in this role must possess experience with analytical strategy, strong problem solving abilities, technical skills, particularly with data visualization, project management skills and the ability to develop strong relationships across departments. Day-to-day projects include: managing the Medicare Advantage bid from an actuarial perspective; developing and opining on all internal assumptions as well as reviewing the work of external consultants; presenting financial projections, impacts and potentially ROI as it relates to product design or corporate initiatives as a part of the bid process; analyzing and evaluating previous strategic decisions; and developing dashboards that tell the MA “story” as it relates to product design, member movement, and geographic footprint as it relates to profitability.

Key Responsibilities:

  • Work closely with the Medicare Advantage product team to refine product strategy, outline a project plan, develop strategic dashboards and present resulting product design impacts and projections to leadership.
  • Develop assumptions, models, forecasts, pricing impacts and documentation associated with the annual Medicare Advantage bid submissions, related strategy and any associated audits.
  • Stay up to date on all CMS releases applicable to Medicare Advantage and Part D as it relates to actuarial work.
  • Monitor results and trends of existing and new products’ relative performance versus expectations and the industry.
  • Manage the needs of various stakeholders as it relates to the Medicare Advantage bid including proactive communication, managing project timelines and formal presentations to stakeholders.

Requirements

  • Must possess a Bachelor’s Degree in Math, Actuarial Science, Economics, Computer Science or related field
  • Minimum of 4-5 years of experience leading Medicare Advantage bids
  • ASA preferred but not required
  • Requires knowledge of financial and accounting concepts as well as an extensive knowledge of spreadsheets and database software
  • Experience with actuarial forecasting models and projections
  • Ability to work independently and under minimal supervision on projects/tasks assigned
  • Well organized and able to work on multiple projects simultaneously
  • Strong technical skills in using Microsoft Office products
  • Possess a collaborative attitude and work well with others

Other Preferred Skills

  • Basic programming skills in SQL, SAS or R
  • Experience using Tableau or other visualization software
  • Advanced Excel ability including writing VBA macros

Johns Hopkins Health System and its affiliates are Equal Opportunity/Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sexual orientation, gender identity, sex, age, national origin, disability, protected veteran status, and or any other status protected by federal, state, or local law.

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