Kelsey-Seybold Clinic
Responsibilities
Kelsey-Seybold Managed Care Analytics exists to monitor and improve the financial performance of Kelsey-Seybold (KS) by providing actionable, data-driven insights to the organization. Within Managed Care Analytics, the Actuarial Services team’s primary focus is to apply actuarial science rigor to pricing, forecasting, and broader analytical exercises.
The Actuarial Services Manager will lead the development of Kelsey-Seybold capitation rates, projections related to shared savings agreements, benefit modeling, and ongoing financial/trend analysis. The Manager will collaborate with internal and external stakeholders to examine product strategy and assess impact of regulatory and contractual changes.
Key responsibilities of this position include:
- Leading the commercial capitation process including development of projections and assumptions and maintaining all pricing data and assumptions in an organized manner
- Developing, producing, and analyzing reports and data required to understand the key drivers of the relevant business unit or service line including the monthly unpaid claim liability/IBNR estimates, monthly reconciliation of financials to incurred reporting, and revenue and cost trend analysis
- Recruiting and developing a team of analysts
- Participating as a key member in strategy discussions and meetings with the KS executive team
Job Title: Manager Actuarial Services
Clinic Location: Pearland Administrative Office Building
Department: KS Plan Advantage-Hlth Care Fi
Job Type: Full Time
Salary Range: $119,850 – $148,054 (Pay is based on several factors including but not limited to education, work experience, certifications, etc.)
Qualifications
Education
Required: BA/BS Degree in Economics, Mathematics, Actuarial Science or other related field.
Preferred: N/A
Experience
Required:
- 7+ years of experience in healthcare, data analytics or a related field including:
- 5+ years of experience supervising or managing teams and/or projects
- 3+ years of actuarial and/or underwriting experience
- Demonstrated knowledge of IBNR models
- Demonstrated knowledge of actuarial cost analysis and PMPM modeling
- Demonstrated knowledge of medical insurance products and the ability to analyze and assess risks are required
Preferred: Prior systems experience (i.e. enrollment/eligibility, capitation, claims payment, etc.) with an MCO.
License(s)
Required: Associate of the Society of Actuaries(ASA) for Fellow of the Society of Actuaries (FSA)
Preferred: N/A
Special Skills
Required:
- Advanced proficiency in Microsoft Excel
- Basic knowledge of Microsoft Power Point and Microsoft Word
- 2+ years of programming experience in SQL, SAS or similar application language
- Experience writing, debugging and documenting complex queries against relational databases
Preferred:
- Experience with reporting tools (including Crystal Reports and Microsoft Access)
- Experience with PowerBI or other data visualization tools
- Familiarity with EPIC and Clarity reporting data warehouse
Other
Required:
- Fluent in English both verbal and written, effective communicator
- High level of accuracy with excellent attention detail
- Strong organizational and time management skills
- Proven ability to work in a dynamic setting and balance multiple priorities while meeting deadlines
- Superior analytical skills
- Ability to communicate complex information in a clear and concise manner
- Ability to motivate others and function as a working manager
Preferred: N/A
Working Environment: Office
About Us
Start your career journey and become a part of a community of renowned Healthcare professionals. Kelsey-Seybold Clinic is Houston’s fastest growing, multispecialty organization with more than 40 premier locations and over 65 specialties. Our clinics are comprised of more than 600 physicians and as we continue to grow, our focus is providing quality patient care by adding to our team of clinical and non-clinical professionals that work together in a convenient, coordinated, and collaborative manner. Enjoy the rewards of a successful career while maintaining a work/life balance by joining our team today and changing the way health cares.
Why Kelsey-Seybold Clinic?
- Medical, Vision, and Dental
- Tuition Reimbursement
- Company Matching 401K
- Employee Reward and Recognition Program
- Paid time off for vacation, sick, and holidays
- Employee Assistance Program
- Continuing Medical Education allowance