Actuarial - Healthcare Economist

Summary The Actuarial – Healthcare Economist performs actuarial analysis pertinent to FCS businesses, including the Value-Based Care Program Portfolio and the analysis and supportive development of new alternative payment models and population health management. This individual should be proficient in actuarial science methodologies and develop / use relevant tools, databases, and record systems to gather and synthesize information for interpretation. The Actuarial – Healthcare Economist will provide detailed analysis, build forecasting models, consult with business leaders, and provide advice and recommendations for risk assessment and mitigation efforts across business units. They will assess affordability analytics in support of medical cost reduction, quality of care improvement, and increase in high-value care delivery and patient satisfaction. Additionally, they will prepare projections for market trends and relevant impacts to VBC programs using healthcare economics techniques and methods. This individual may also oversee actuarial or underwriting staff. Primary Tasks and Responsibilities Maintain working knowledge of current value‑based care contracts, programs, and initiatives. Collaborate with cross‑functional teams to develop and implement value‑based care models, payment structures, and reimbursement mechanism that align with incentives with improved patient outcomes / high value care. Conduct in‑depth analysis of healthcare data, claims utilization patterns, and cost trends to inform the development of actuarial models and economic forecasts. Provide expert guidance on healthcare policy implications, regulatory changes, and market trends that may impact value‑based care strategies. Work closely with data scientists and healthcare professionals to design and refine models for risk adjustment, cost‑sharing, performance measures. Collaborate with internal and external stakeholders to communicate complex findings in a clear and concise manner, including presentations, reports, and recommendations. Assess the financial impact of proposed value‑based care programs, utilizing actuarial methodologies and economic principles to forecast potential incentives and risks. Develop detailed analysis, build forecasting models, and trend analysis to present to key leaders and decision makers. Education, Certifications & Licenses Bachelor’s degree (B.A.) in actuarial science, healthcare economics, quantitative analysis, mathematics, or a closely related field; statistics background would prove helpful in this role. Master’s degree in healthcare economics, Actuarial Science, Economics, analytics, or related field preferred. ASA or FSA designation with ability to sign pricing and reserving opinions a plus. Experience Experienced healthcare economist or actuary, preferably with a large‑scale payer or equivalent solution provider. Experience with healthcare actual and underwriting functions required to successfully meet the needs of understanding organizational risk. Proficiency in database querying tools and strong data management skills. Strong understanding of data systems and sources and how it impacts the data available. Working knowledge of medical claims, billing practices, and health insurance requirements. Experience in building forecasting models and conducting budget impact analysis. Knowledge of actuarial landscapes of payers, the value metrics they use, principal calculation methods. Core Competencies, Knowledge/Skills/Abilities Analysis & Critical Thinking; using resources available to solve problems and research solutions independently. Strong interpersonal skills to include effective verbal and written communication. Solid time management with the ability to prioritize multiple tasks. Must have strong organizational skills to prioritize tasks independently and track performance, communications, and outreaches to assigned territory. Ability to collaborate across various levels of management, departments, and teams. Must be comfortable with providing timely feedback in remote and in‑person setting to physician and operational leadership clientele. Comfortable negotiating problems and exploring solutions with physician, upper management, and FCS leadership. Values Patient First – Keeping the patient at the center of everything we do. Accountability – Taking responsibility for our actions. Commitment & Care – Upholding FCS vision through every action. Team – Working together, one team, one mission. Screenings Background, drug, and nicotine screens. Safeguarding our patients and each other is an important part of how we deliver the best care possible to the communities we serve. All offers of employment at Florida Cancer Specialists & Research Institute are contingent upon clear results of a thorough background screening. Additionally, as a condition of employment, FCS requires all new hires to receive various vaccinations, including the influenza vaccine, barring an approved exemption. In addition, FCS is a drug‑free workplace, and all new hires will be subject to drug/ nicotine testing. Medical Marijuana cards are not recognized. EEO Statement EEOC Florida Cancer Specialists & Research Institute (FCS) is committed to helping individuals with disabilities to participate in the workforce and ensure equal opportunity to compete for jobs. If you require an accommodation to submit a resume for positions at FCS, please email FCS Recruitment (View email address on click.appcast.io) for further assistance. Please note this email address is intended to request an accommodation as part of the application process. Any other correspondence will not receive a response. FCS is an EEO/Affirmative Action Employer and does not discriminate on the basis of age, race, color, religion, gender, sexual orientation, gender identity, gender expression, national origin, protected veteran status, disability or any other legally protected status. Benefits Medical and Prescription Drug Coverage. Vision & Dental Insurance. Employee Assistance Program (EAP). Health Savings Account (HSA) & Flexible Spending Accounts. Paid Time Off (PTO). 401(k) Retirement Plan. Life Insurance. Tuition Reimbursement. Disability Insurance. Accident Insurance. Critical Illness. Hospital Indemnity. Pet Insurance. Identity Theft. Legal Insurance. #J-18808-Ljbffr Florida Cancer Specialists & Research Institute