Manages actuarial services for provider relations, value-based contracting, forecasting, pricing, reserving, and risk assessment. Defines contract performance measures and benchmarks, validates statistical methodologies, supervises actuarial analysts, monitors insurance risk profiles, analyzes key drivers, and presents findings to senior financial leadership. Requires expertise in health insurance, managed care, commercial and government programs, Medicare pricing, medical economics, and risk adjustment.
Company Highlights
- This top ranked Healthcare Company was awarded the #2 “Best Places to Work for Women & Diverse Manager” by Diversity MBA Magazine.
- U.S. News & World Report consistently ranks this company among the nation’s best hospitals in many specialties.
- This company provides generous merit increases, two-week parental leave, and true work-life balance
Benefits and Features
- Medical insurance, including prescription and vision coverage; Dental Insurance
- Flexible spending accounts
- Disability coverage plus basic life and accidental death and dismemberment (AD&D) insurance
- Supplemental life and AD&D insurance for employee
- Supplemental life insurance for employee's spouse and children
- Cash balance plan
- Savings plan
- Paid time off (PTO) and holiday pay
- Tuition assistance for employees, their spouses, and eligible dependents
- Adoption assistance
The Role You Will Play
- The Actuarial Manager, Value-Based Contracts ensures that the Actuarial Department provides excellent services to various internal and external clients in the areas of provider relations, contracting and forecasting.
- The Manager determines the performance measures, associated benchmarks, and other contractual components to include in new-formed value-based contracts as well as assures reliability of measures and statistical methodologies in tracking performance.
- In addition, this role will supervise actuarial analysts.
- This role is entrusted to work closely with Enterprise Risk Management and key internal stakeholders to build and enhance insurance (underwriting and reserving) risk assessment, monitor changes to the risk profile, risk analytics, and understand key drivers as well as present to senior financial leadership.
Community Highlights
- The position can work from a remote home office based within the United States.
- This company is headquartered in Pittsburgh, PA
Background Profile
- Expertise in actuarial value-based contracting, commercial pricing, Medicare pricing, reserving, medical economics, and Medicare or Medicaid risk adjustment.
- 6+ years of progressive Actuarial experience in health insurance, managed care, or related consulting business
- Familiarity with commercial and government health programs
- ASA or FSA required
- Bachelors’ degree in Mathematics, Actuarial Science, or related field
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What you need to know about the Boston Tech Scene
Boston is a powerhouse for technology innovation thanks to world-class research universities like MIT and Harvard and a robust pipeline of venture capital investment. Host to the first telephone call and one of the first general-purpose computers ever put into use, Boston is now a hub for biotechnology, robotics and artificial intelligence — though it’s also home to several B2B software giants. So it’s no surprise that the city consistently ranks among the greatest startup ecosystems in the world.
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- Number of Tech Workers: 269,000; 9.4% of overall workforce (2024 CompTIA survey)
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