Senior Director, Actuarial Services

Your Future Evolves Here
Evolent Health has a bold mission to change the health of the nation by changing the way health care is delivered. Our pursuit of this mission is the driving force that brings us to work each day. We believe in embracing new ideas, challenging ourselves and failing forward. We respect and celebrate individual talents and team wins. We have fun while working hard and Evolenteers often make a difference in everything from scrubs to jeans.
Are we growing? Absolutely--62% in year-over-year revenue growth through 2015. Are we recognized? Definitely. We're 12th on Forbes' list of America's Most Promising Companies for 2015, one of "Becker's 150 Great Places to Work in Healthcare" in 2016, and our CEO was number one on Glassdoor's 2015 Highest-Rated CEOs for Small and Medium Companies. If you're looking for a place where your work can be personally and professionally rewarding, don't just join a company with a mission. Join a mission with a company behind it.
What You'll Be Doing:
Senior Director, Actuarial Services will take a lead role in market pricing, reporting and contracting for Evolent's clients. This role will involve both supporting client strategic business development as well as leading implementation and ongoing operations for client plans/products with a particular focus on Risk Adjustment projection and optimization for Medicare and other Lines of Business, as well as Medicare Advantage pricing/bid development. This position will help drive clients' market-driven strategy to product development and ongoing financial management. The ideal candidate would be located in the Washington DC/VA area.
Managing and coaching teams of actuaries
Role interacts with internal operations, Evolent clients as well as actuarial consultants
Leading actuarial analysis and services in support of claims analysis, financial projections and pricing/product strategy
Balancing growth and profitability goals to maximum results
Assisting with and participating in negotiations and presentations where appropriate
Leading actuarial support for the organization's RAF strategy across multiple product lines (MA, ACA, NextGen ACO, etc.)
Offering strategic oversight of the organization's Medicare Advantage bid development
Incorporating organizational expectations for the financial impacts of clinical integration, population management processes, provider contracts and benefit structures into rates and financial projections
Presenting reports and analyses to clients and internal executives
Partnering with sales team to support proposals
Leading periodic acquisition of reinsurance coverage for applicable product lines
The Experience You Need (Required):
B.S. in Actuarial Science, Math, Economics or related degree
ASA designation
8+ years of experience in a health actuarial setting; prior rate filing experience
Experience with various risk adjustment models, including the CMS-HCC Risk Adjustment model
Deep understanding of Risk Adjustment Factor methodology and approaches to support accurate coding
Finishing Touches (Preferred):
FSA designation
Experience with provider directed health plans
Experience in developing pricing methodologies, unpaid claims reserves and provider contract analysis for individual and group medical linesExcellent communication and presentation skills. Must be comfortable presenting complex analyses to internal and external client executives
Strong technical skills required in Microsoft office
Collaborative working style with the ability to work across different organizations and personalities
Ability to work independently, multitask, prioritize, adapt to change, work well under pressure in an entrepreneurial environment, and manage a project from start to finish
Proven leadership to engage, inspire, and manage a team or staff
Evolent Health is an Equal Opportunity/Affirmative Action Employer

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