Actuary - St. Luke's Health Partners
US-ID-Boise
careers
Req #: 100189
Type: Full-Time
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Overview: St. Luke's Health Partners (Health Partners) is a wholly owned subsidiary of St. Luke's Health System, and a financially and clinically integrated network of providers improving the health outcomes of the population and lowering the cost of care through value-based care strategies. We foster a collaborative and innovative work environment that values cross-functional teamwork, data-driven decision-making, and a healthy work-life balance. The Health Partner's Actuary is a crucial strategic partner in advancing the organization's financial and clinical goals by evaluating financial risk, forecasting cost and utilization trends, and providing actuarial leadership to guide pricing, reimbursement strategy, and performance optimization across all lines of business - Medicare, Medicare Advantage, Exchange, and Commercial. The ideal candidate will possess strong analytical acumen, a deep understanding of healthcare data, and the ability to translate complex actuarial insights into actionable strategies for Health Partners leadership and key stakeholders. What you can expect: * Develops and maintains analyses to inform business decisions to meet market and financial goals. * Evaluates industry, economic, and financial trends to forecast the organization's competitive position. * Ensures products are appropriately priced, financial positions are appropriately stated and projected, and ensures leaders and key stakeholders are appropriately informed to make strategic decisions. * Models and informs on premium or target rating structures for new and existing products. * Analyzes and develops financial statement reserves and other liabilities, including IBNR (incurred but not reported), risk settlements, incentive and risk-share payments, and reinsurance claims. * Make recommendations based on the analysis of information regarding methods to reduce costs. * Provides strategic and financial advice in the contracting process, utilizing actuarial models, analyzing healthcare cost and utilization data, and completing actuarial calculations. * Develops, analyzes, and reports on facility, physician, and other provider reimbursement structures. * Makes recommendations based on the analysis of information regarding methods to reduce costs through benefit design modifications. * Supports ad hoc analyses to support data-driven insights to answer specific business needs that arise from Health Partners leadership and other stakeholders. * Communicates regularly with financial directors and internal/external stakeholders at all levels. * Possesses a comprehensive working knowledge of the subject matter and provides subject matter expertise. Qualifications: * Bachelor's Degree * 4 years of relevant experience * Associate of the American Society of Actuaries (ASA) or Fellow of the American Society of Actuaries (FSA) Responsibilities: Provides healthcare actuarial expertise for all lines of business, contributing to the organization's financial soundness. This role is responsible for researching and determining the likelihood of financial risk to the organization, developing and designing actuarial documentation, and assessing and interpreting financial risk and opportunity analyses. * Develops and maintains analysis to inform business decisions to meet market and financial goals. Provides reporting of claims experience. * Evaluates industry, economic, and financial trends to forecast the organization's competitive position. * Presents and communicates complex actuarial concepts and concerns to Network leadership and key stakeholders across the organization. Develops and refines strategies that minimize risk and costs. * Ensures products are appropriately priced, financial positions are appropriately stated and projected, and ensures leaders and key stakeholders are appropriately informed to make strategic decisions. * Analyzes and develops financial statement reserves and other liabilities including IBNR (incurred but not reported), risk settlements, incentive and risk-share payments, and reinsurance claims. * Models and informs on premium or target rating structures for new and existing products. Supports payer contracting and finance in pricing conversations. * Develops, analyzes, and reports on facility, physician, and other provider reimbursement structures. * Makes recommendations based on the analysis of information regarding methods to reduce costs through benefit design modifications. * Supports ad hoc analyses to support data-driven insights to answer specific business needs that arise from Network leadership and other stakeholders. * Possesses comprehensive working knowledge of subject matter and provides subject matter expertise. Makes decisions on moderately complex to complex issues regarding technical approach. Exercises considerable latitude in determining objectives and approaches to assignments. * Other duties and responsibilities as assigned. Qualifications: Education: Bachelor's degree Experience: 4 years relevant experience. Licenses/Certifications: Associate of the Society of Actuaries (ASA)
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