Duly Health and Care · 15 hours ago
VBC Actuary
Downers Grove, IL
Full-time
Onsite
Senior Level
$107K/yr - $160K/yr
5+ years expDuly Health and Care is committed to helping team members flourish in all aspects of their lives. They are seeking a VBC Actuary to manage the IBNR healthcare claims process, serve as a subject matter expert, and support financial analyses related to value-based care.
Health CarePersonal HealthWellness
Responsibilities
Performance and maintenance of the monthly incurred but not reported (IBNR) healthcare claims process for a large risk based multi-specialty value-based care organization. Serve as a subject matter expert on IBNR estimates and payor data files. Investigate and analyze utilization and medical cost data in support of financial close, budget, and forecasting processes
Create the monthly claim triangles, populate the IBNR models, and produce the IBNR estimates, working closely with accounting, finance, and operational leaders. Communicate results and supporting information to internal audiences including Finance, Accounting, and Value Based Care executives and team members. Maintain the IBNR models. Research issues and trends and keep leaders informed of findings. Update related monthly reports. Act as key contributor and subject matter expert during budget and forecast cycles. Interact with payor contacts and third-party actuaries as appropriate. (70%)
Support the annual financial statement audit. Prepare lookback analyses and other information as requested by the auditor. Meet with the auditor as needed to answer questions. (5%)
Perform medical expense projections and evaluate against payor contracts. (10%)
Perform ad hoc analyses as requested by management. Independently surface insights and recommendations that help improve the accuracy of IBNR models and/or value-based care operations. (15%)
Role is viewed as a primary subject matter expert on all matters related to IBNR and will be looked to for advice, guidance, and mentorship
Manage entire IBNR process, on a monthly basis, to completion, meeting predetermined timelines
Qualification
Required
Associate of the Society of Actuaries (ASA)
Member of the American Academy of Actuaries (MAAA)
BS or BA in Actuarial Science, Mathematics, Statistics, Economics, or a related area
Minimum of five years of US healthcare actuarial work experience in managed care or closely related field, with at least 2 years estimating IBNR claims
Experience supporting the monthly IBNR process (preferably 3+ years)
Experience developing and maintaining complicated EXCEL/VBA models and presenting results (preferably 7+ years)
Knowledge of IBNR methodologies and concepts
Strong understanding of the US healthcare system
Ability to work effectively with other team members, auditors, payor contacts, and third-party actuaries
Ability to communicate complex concepts to technical and non-technical audiences
Understanding of financial statements
Understanding of relational databases
Understanding of medical and pharmacy trends
Understanding of medical claims coding and categorization
Advanced knowledge of Excel
Knowledge of SQL/Databricks
Ability to identify and drill down into causes of changes in medical expenses
Preferred
Ability to write and edit VBA macros preferred
Benefits
Comprehensive medical, dental, and vision benefits that include healthcare navigation assistance and medical coverage at 100% (after deductible) when utilizing a Duly provider.
Employer provided life and disability insurance.
$5,250 Tuition Reimbursement per year.
Immediate 401(k) match.
40 hours paid volunteer time off.
A culture committed to community engagement and social impact.
Up to 12 weeks parental leave at 100% pay and a financial benefit for adoption and surrogacy for non-physician team members once eligibility requirements are met.
Company
Duly Health and Care
Duly Health and Care is a Midwest-based independent, multi-specialty physician-directed medical group.
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Daniel Greenleaf
Chief Executive Officer
Abigail Kleber
Talent Access Partner
Recent News
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