About Tomorrow Health
Tomorrow Health enables exceptional healthcare for patients and their families in the place they want to be most — home. At Tomorrow Heath, we build technology that rewires the way home-based care is ordered, delivered, and paid for. Tomorrow Health connects patients, providers, health plans, and home-based care suppliers, to ensure patients receive the correct and timely care they need to remain healthy at home.We believe in putting patients first, that many perspectives are stronger than one, and in treating those we serve just as we would our own family members.
We hope you’ll join us if you’re passionate about improving healthcare delivery, leveraging technology to help people, and working in a collaborative, diverse environment.
The Role
We are looking for a Senior Director of Actuarial Services who will report directly to the VP, Chief Actuary. This person will work closely with various functions within the company to drive meaningful analytics and decision making, operational, financial and clinical. The position will also support pricing of risk deal proposals and work closely with IT to develop useful internal reporting capabilities.
Who you are
- You are an actuary with deep experience working in the value based care space and working with data supplied by clients in a mid stage start-up environment. You have exceptional skills with software such as R, SQL and/or SAS being able to analyze large amounts of payor data and are adept in building predictive models. You also have a background in statistics and experience in evaluating the efficacy of programs. Key areas in which you will support the Chief Actuary:
- Forecasting: Supporting finance in developing shared savings forecasts and costs as well as dynamic models for scenario testing to help manage risk
- Pricing: Develop pricing models reflecting our different product offerings under varying financial risk structures.
- Benchmarking and target setting: Develop appropriate benchmarks for unit cost and utilization comparison and set performance targets agreed upon with clinical and finance
- Medical Economics: help build the capacity to understand the key drivers of costs in Tomorrow Health’s “at risk” populations and formally track efforts at Tomorrow Health to impact those trends
Responsibilities
- Develop product pricing models and underwriting process including relevant benchmarks.
- Analyze CMS, State Medicaid, and Health Plan claims data files (all LOB) and alert team of any data concerns
- Work with Chief Actuary and external data/resources to help set appropriate trends for DME POS space
- Create applicable data models and aggregate, review, and analyze applicable data for various proposals and projects.
- Devise, collect, maintain, and report financial and statistical information required to monitor cost and utilization trends for all products in order to assure accuracy of the factors and benchmarks used in the ratings and financial arrangements with health plans.
- Track and project trend rates for all products across all lines of business, including Medicaid, Medicare Advantage, Duals, Commercial and ACA Marketplace.
- Assist in Tomorrow Health’s forecasting efforts, including working with Finance, Operations, and other analytics teams.
- Develop reserving process to enable appropriate risk accruals for financials
- Support chief actuary and product/sales team in negotiation process for new clients as well as settlements
Requirements
- 8-10+ years of proven experience as an actuarial director in a healthcare setting, ideally with 5+ years of experience in value-based care at either a tier one Actuarial firm, tier one health plan, or post-acute/home based specialized care vendor.
- Deep familiarity with government healthcare programs and policies, particularly Medicare, Medicare Advantage, Medicaid, and the Affordable Care Act.
- Strong ability to communicate complex actuarial concepts and engage with various stakeholders,within Tomorrow Health and clients
- A strong record of collaboration with other leaders, including clinical and operations, to help drive business solutions
- Deep understanding and familiarity with claims data analytics and pricing model development for all lines of business (Medicare Advantage, Medicaid, Duals, Commercial and ACA Marketplace)
- Strong quantitative skills, including experience with statistical analysis and predictive modeling in healthcare contexts. Deep experience with Excel, Tableau, SQL, ProVal, GGY, Axis, VBA, Access and other similar tools.
- Associate-Level Certification from the Society of Actuaries or similar credential required.
- Experience leading actuarial or similar function at an organization that is ‘at risk’ for the cost of medical care, such as an at risk provider system, payer, or contractor.
- Proactive and results-oriented mindset, excelling in the rapid pace of startup environments.
- Commitment to ethics and integrity.
- Position can be remote.
Benefits
- 100% employer-paid medical, dental and vision benefits
- HSA and FSA (Dependent Care and Commuter)
- Fully covered membership in One Medical for on-demand primary care, and Teladoc for 24/7 virtual care
- 12 weeks of paid parental leave for all caregivers
- Free mental health support with BetterUp through Health Advocate EAP
- Short-term, and long-term disability plan availability
- Company-sponsored Life and AD&D insurance
- Educational reimbursement
- Monthly wellness stipend
- Commuter Benefits
- Access to Vanguard 401k plan
- Unlimited vacation and 11 corporate holidays
Compensation range for this position: $160,000 - $190,000/yr depending on experience and qualifications, plus equityLearn more about our core values and working with us on our careers page and Interview Guide! Tomorrow Health is an Equal Opportunity Employer and does not discriminate on the basis of race, religion, color, sex, gender identity, sexual orientation, age, non-disqualifying physical or mental disability, national origin, veteran status or any other basis covered by appropriate law.
