Actuary - VBC

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
 

Position Purpose:  Centene is seeking a highly motivated, experienced, and independent Actuary to join our dynamic Vendor Analytics team. This critical role focuses on the financial engineering, analysis, and negotiation of Value-Based Care (VBC) arrangements with external vendors across our Medicare, Medicaid, and ACA lines of business.

In this Actuary role, you will:

• Apply knowledge of mathematics, probability, statistics, principles of finance and business to design, model, financially engineer, and evaluate complex Value-Based Care (VBC) financial arrangements and associated vendor contracts
• Lead the development of sophisticated financial models to assess financial risk and opportunity associated with proposed and existing VBC arrangements (e.g., shared savings/risk, capitation, bundled payments, specialty carve-outs).
• Provide robust analytical support and subject matter expertise during negotiations with external vendors, defend analytical methodologies, and clearly articulate the company's financial positions related to VBC arrangements.
• Collaborate effectively with internal matrix partners (including, but not limited to, Medical Economics, Enterprise Partnerships, Network Management, Clinical Operations, Finance, and Data Analytics teams) to ensure VBC strategies are analytically sound, operationally feasible, and aligned with enterprise goals.

Why this role is appealing?

• High Impact: Directly shapes multi-million dollar VBC contracts and influences key strategic decisions related to vendor partnerships.
• Autonomy & Ownership: Significant independence to lead complex workstreams, solve problems, and drive initiatives.
• Intellectual Challenge: Requires sophisticated analytical modeling, financial engineering, and strategic thinking in the evolving VBC landscape.
• Visibility: Opportunity to work closely with senior leaders internally and negotiate with external vendor executives. 
• Team & Leadership:  We foster a collaborative environment where analytical rigor is valued.  Leadership is rooted in a supportive, trust-based style that empowers team members to take ownership of their work while ensuring they have the resources and support needed to succeed.

Education/Experience: Bachelor's degree or in related field or equivalent experience. 5+ years of actuarial experience.

License/Certification: Associate of the Society of Actuaries (ASA) (or equivalent international certification); Member of American Academy of Actuaries (or equivalent international membership)

Preferred Skills & Experience:

• Healthcare Analytics & Actuarial Expertise: Minimum of 5+ years of experience in healthcare analytics, actuarial science, or data science within a health plan, managed care organization, provider system, or consulting firm. Strong preference for hands-on experience in Value-Based Care (VBC) contract modeling, financial engineering, and analysis within a payer environment.
• Managed Care Expertise: Familiarity with Medicare, Medicaid, and ACA programs within managed care settings is highly valued.
• Technical Proficiency: Advanced Excel modeling, strong SQL skills, and a solid understanding of healthcare data structures. Experience with data visualization tools (e.g., Tableau, Power BI) and statistical programming languages such as R or Python is a plus.
• VBC & Financial Modeling: Deep understanding of various VBC models (e.g., shared savings/risk, capitation, bundled payments), including baseline setting, risk adjustment, performance metrics, and reconciliation logic.
• Communication & Negotiation: Proven ability to negotiate complex financial and analytical terms externally and communicate sophisticated concepts clearly to both technical and non-technical audiences.

*Applicants for this job have the flexibility to work remote from home anywhere in the Continental United States*

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status.  Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act