Vice President, Actuarial Services

2 days ago

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Belong Health

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Healthcare Insurance • SaaS • Artificial Intelligence

Belong Health is a company focused on providing comprehensive healthcare solutions, particularly aimed at serving complex and high-need communities. The company enhances existing health plan infrastructures by offering tailored solutions to better support individuals with complex needs. Belong Health collaborates with insurance product leaders across health plans and systems to simplify the process of launching new healthcare insurance products, thereby improving access to and the quality of care for complex-needs patients. Their innovative approach includes leveraging AI tools to revolutionize care management with a human-centric approach.

11 - 50 employees

⚕️ Healthcare Insurance

☁️ SaaS

🤖 Artificial Intelligence

📋 Description

• Build executive performance and operational dashboards to provide visibility and access to key metrics, define targets for KPIs, and track progress against targets. • Build and manage healthcare tools, savings methodologies and reporting. • Identify and resolve data quality issues and maintain a robust measurement and reporting audit process for routine reports and measures. • Implement and design risk stratification approaches, analysis of key metrics, and development of new analytics. • Utilizing payor data and reporting to generate VBC Performance monitoring. • Setup and utilize Risk Accrual models to estimate final revenues from payors. • Examine claims data to determine appropriate IBNR for VBC contracts. • Help craft strategy for ACO and MAPD. • Responsible for developing policies, practices, and procedures that have a significant impact on organizational decisions. • Incorporates new data sources, predictive modeling, and application of visualization tools. • Represent Belong Health and our analytic capabilities with external provider partners and/or payors, to ensure they deeply understand current capabilities. • Lead and direct the work of other employees including hiring, performance management, and coaching. • Collaborate with other members of the executive management team to align departmental strategy or direction with the overall goals of the organization. • Collect and analyze data to estimate the probability of certain events taking place. Uses estimations to develop, test, and administer policy adjustments based on these inferences. • Perform other related duties as assigned.

🎯 Requirements

• Has work experience in one or more of the following: Medicare Advantage, MSSP, ACO Reach, or other Value Based Care experience. • Has a proven track record of leading a highly skilled team that drive results. • Strong skills in collaborative working relationship with the team and stakeholders. • Strong analytical, problem-solving, and business skills to extract implicit, unstated, and unrecognized requirements. • Excellent verbal, written communication and presentation skills. • Strong analytical and strategic skills required. • Metrics driven. • Ability to manage multiple priorities and projects. • Must be proficient in SQL, Tableau, Microsoft Office. • Demonstrate proactive service skills and effective stakeholder management. • Self-starter with innate desire to learn.

🏖️ Benefits

• Health insurance • Retirement plans • Paid time off • Flexible work arrangements • Professional development