Actuarial Analyst II

Delaware Valley Accountable Care Organization (DVACO), located in Radnor, PA has a newly created opportunity for Actuarial Analyst II

The DVACO is a limited liability joint venture corporation comprised primarily of two major health systems: Jefferson Health and Main Line Health, serving the Greater Philadelphia region and southern New Jersey. DVACO was accepted into the Medicare Shared Savings Program for the 2014 start year, and now includes 2,000 physicians serving over 180,000 lives. DVACO contracts with four commercial payers and serves Medicare beneficiaries, making it the region’s largest Accountable Care Organization. At the core of operations, DVACO is committed to working towards the achievement of the triple aim: better outcomes, better experiences, and smarter spending. Our culture embraces innovation of healthcare delivery models through collaborative work with physician practices, health systems and employee wellness programs.

Why Work for Main Line Health?
We are committed to providing exceptional care with empathy and compassion for people at all stages in life. Our Diversity, Respect and Inclusion Initiative celebrates our differences and our similarities. Ultimately, we want everyone to feel respected for who they are.

The Actuarial Analyst II will be assist\lead with the development of new measures and metrics, creates new reports and analytical solutions, produces analytics used to measure quality and efficiency performance quantifying DVACO, MLH\JHS PODs and other associated business partners’ performance in multiple Value Based Purchasing contracts.

Responsibilities include supporting the various reporting and analysis needs of the DVACO and the PODs (i.e., JHS \ MLJ Integrated Network (CIN).

ESSENTIAL ACCOUNTABILITIES:

  • Produces system-wide reporting and performance management arrays in support identifying open care gaps, utilization leakage/keepage and other revenue enhancement opportunities.
  • Develops analytics to clearly identify drivers of adverse trend performance and/or benchmark achievement.
  • Develops and/or utilizes existing actuarially sound models in support of predictive analytics, risk adjustment and benchmark models.
  • Creates and presents executive level summaries that clearly depict performance and opportunities for improvement in all value based purchasing programs.
  • Executes analytic processes required to support population health at Jefferson, including but not limited to case-mix adjusted physician profiling; operational, quality, cost and utilization analytics; risk analytics; trending and forecasting; predictive modeling; program evaluation using advanced techniques; actuarial analyses; and data mining.
  • Continuously develops data expertise needed to optimally use business and other data to support population health reporting and analytics tools and processes; includes expert data knowledge, quality control and following appropriate standards.
  • Participates in all required meetings, educational overview sessions, product implementation and review sessions as communicated by the Manager, Actuarial Informatics
  • Effectively collaborates with team peers, other Enterprise Analytics team members and partners throughout the business.
  • Communicates effectively within informal and formal channels, including written communications, presentations and informal communications with peers, management and business partners.
  • Acquires knowledge about DVACO and JHS\MLH Pods system and processes, as required to support population health reporting.
  • Interacts with co-workers, visitors, and other staff consistent with DVACO values.

QUALIFICATIONS:

Education:

BS required in Business, Mathematics, IT or data relevant field

Experience:

Minimum of 3 years related professional work experience in a progressive healthcare setting required. One year of experience may be granted for passage of at least one or more Society of Actuarial (SOA) exams or active in the Exam Program.

Technical Skills\Capabilities

  • Maintains proficiency and expertise in Health Plan data applications, state of the art business intelligence software and reporting tools that include, but are not limited to, MS SQL Server Components (Query Analyzer & coding, SSRS, Analysis Server, Stored Procedures, Jobs, and Functions), Business Objects (Tableau, Qlik, Crystal Reports, Crystal Enterprise, Crystal Analysis and OLAP), SAS, Microsoft Office (Word, Excel, PowerPoint, and Access) and grouper and predictive modeling software (3M and CGI) to prepare complex multi-factorial analysis. Synthesizes and Interprets analyses.
  • Capable of programming in SAS, SQL Query Construction or other programming language.

Other Skills\Capabilities

  • Demonstrates strong mathematical, statistical, financial, technical, interpersonal, organizational, project management skills, and ability to maintain confidentiality.
  • Demonstrated ability to identify problem areas and take initiative to identify and implement appropriate solutions Self-motivated

We offer competitive compensation and outstanding comprehensive benefits including tuition reimbursement, 403B matching savings plan and a pension plan. If interested, please apply online at https://www.mainlinehealth.org/careers , Job ID 45573

Applicants must certify that they have not used tobacco products or nicotine in any form in the 90-days prior to submitting an application to Main Line Health. This will be verified during pre-employment testing. We are an Equal Opportunity Employer. Please, no agency calls