Senior Manager, APM Modeling & Analytics

Job not on LinkedIn

🕒 March 23

🇺🇸 United States – Remote

💵 $160k - $180k / year

⏰ Full Time

🟠 Senior

👔 Manager

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Arcadia

WebsiteLinkedInAll Job Openings

201 - 500 employees

💰 $29.5M Venture Round on 2020-01

Arcadia is dedicated to happier, healthier days for all. We transform diverse data into a unified fabric for health. Our platform delivers actionable insights for our customers to advance care and research, drive strategic growth, and achieve financial success. For more information, visit arcadia.io.

📋 Description

• Own end-to-end financial modeling for CMS LEAD and other APMs • Translate CMS technical specifications into production-grade actuarial models • Develop and maintain benchmark, attribution, risk adjustment, and reconciliation logic • Ensure integrity of actuarial inputs (e.g., underwriting methodology, pricing assumptions) in value-based contract modeling • Identify model vulnerabilities and proactively mitigate financial exposure • Work directly with CMS VRDC data environments to extract, structure, and analyze Medicare claims and enrollment data • Write production-level SAS and Python code to: • Process large claims datasets • Facilitate risk-adjustments • Calculate, risk adjust, and project PMPM benchmarks • Run sensitivity testing • Conduct reconciliation and true-up calculations • Ensure compliance with CMS methodological guidance • Validate data integrity prior to model production • Establish independent validation standards and ensure consistent adherence to these standards across the enterprise • Create automated testing scripts and exception reporting to implement validation checks, parallel runs, and reconciliation frameworks • Maintain version control, documentation, and auditability of all models at a sufficiently robust level to enable audits or CMS review

🎯 Requirements

• Bachelor's Degree in related Data Science, Actuarial Science, Finance, Economics or related field • Minimum of 6 years of healthcare experience, with a focus on CMS APMs, value-based contracting and analytics • Strong accountability, intellectual curiosity, and customer satisfaction mindset • Experience modeling and evaluating key financial parameters within value-based contracts for health plan or provider • Experience with database querying (SAS, SQL, Python), Amazon Quick Site or BI Tool equivalent

🏖️ Benefits

• Opportunity to lead Arcadia’s most high-profile client partnerships, influencing the direction of our actuarial strategy and product innovation • A seat at the table with Arcadia’s executive leadership, shaping the future of value-based care analytics in the U.S. • Direct access to one of the industry’s largest and most comprehensive healthcare data assets to support groundbreaking actuarial work • A mission-driven culture with the agility of a tech company and the stability of a market leader • A flexible, remote friendly company with personality and heart • Employee driven programs and initiatives for personal and professional development • Be a member of the Arcadian and Barkadian Community