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Financial Analyst (Actuarial Focus)

Humana

Humana

IT, Accounting & Finance
Remote
Posted on Tuesday, June 4, 2024

Become a part of our caring community and help us put health first

The Delaware Valley ACO (DVACO) is an accountable care organization that participates in the Centers for Medicare and Medicaid Services’ Medicare Shared Savings Program (MSSP). DVACO is a joint venture among three stakeholders: Humana, Main Line Health System, and Jefferson Health System. Humana takes the lead in providing administrative support in various areas including HR.

DVACO’s MSSP participation accounts for the region’s largest Medicare ACO grouping, with more than 2,000 physicians and approximately 70,000 Medicare fee-for-service beneficiaries. Additionally, DVACO currently holds performance-based contracts with private payers and manages population health initiatives for the employees and dependents of Jefferson Health and Main Line Health, enhancing DVACO’s total number of beneficiaries to over 200,000.

The Financial Analyst (Actuarial Focus) will be responsible for interpreting data, leveraging analytical tools and making recommendations to key stakeholders at the DVACO. The Financial Analyst is seen as a subject matter expert and will lead DVACO governance committees and maintain ongoing relationships with all levels of management, key third party staff, internal constituents, and external customers at participating Clinical organizations to gather information, share data and effectively move projects forward.

  • Works with Vice Presidents, Medical Directors, Clinical Operations, Finance, Network Contracting, IT and other departments or stakeholders
  • Performs all aspects of financial informatics analysis including data acquisition and data management, advanced SAS or SQL programming, advanced data visualization, quantitative and qualitative data analysis
  • Analyzes and forecasts financial data, medical and pharmacy claims data, and other data to provide accurate and timely information for strategic and operational decisions.
  • Forecasts financial performance in Value Based Contracts using claims data, payer reports, Medicare public use files, etc.
  • Tracks and projects HCC risk scores for contract level reconciliations, calculating risk adjusted key performance indicators, closing gaps, etc.
  • Works with the clinical and financial team to identify trends and patterns in complex data sets, draw conclusions, develop summaries utilizing charts, graphs and images for presentations to stakeholders
  • Works with and educates the leadership team to present statistical and operational reports of key metrics including analysis of progress towards goals and benchmarks
  • Interfaces directly with customers and management to negotiate contract requirements (understand customer needs and provide consultation on options to best meet that need) with customers to ensure optimal value and timely delivery
  • Communicates effectively within informal and formal channels, including written communications, presentations and informal communications with peers, management and business partners.


Use your skills to make an impact

Required Qualifications

  • Bachelor's degree in Actuarial Science, Mathematics, Statistics, Finance, or other related field
  • 1+ years' experience modeling financial performance
  • Prior experience Microsoft Excel (ex. formulas, pivot tables, and graphs), PowerPoint, Word, Outlook
  • Experience with SQL, SAS
  • Prior experience (verbal and written communication) and presentations to both external clients and senior management

Preferred Qualifications

  • 1+ years actuarial experience, or progress in the Society of Actuaries (SOA) exam program
  • Experience modeling financial performance using healthcare claims data
  • Experience in risk adjusted financial analysis and reporting for Value Based Health Care agreements
  • Data visualization (PowerBI/Tableau/Qlik)

Additional Information

This position is Remote with EST hours.

Work at Home/Remote Requirements

Work-At-Home Requirements

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:

At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended; wireless, wired cable or DSL connection is suggested
Satellite, cellular and microwave connection can be used only if approved by leadership
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Humana will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

Our Hiring Process

As part of our hiring process for this opportunity, we will be using an interviewing technology called HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and gain valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule.

Scheduled Weekly Hours

40

Pay Range

The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.


$65,000 - $89,500 per year


Description of Benefits

Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.


About us

Humana Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our Humana insurance services and CenterWell healthcare services, we make it easier for the millions of people we serve to achieve their best health – delivering the care and service they need, when they need it. These efforts are leading to a better quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large.


Equal Opportunity Employer

It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or because he or she is a protected veteran. It is also the policy of Humana to take affirmative action to employ and to advance in employment, all persons regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.