Associate Actuary & Manager – 240287 in Philadelphia, Pennsylvania

Associate Actuary & Manager – 240287

DESCRIPTION/RESPONSIBILITIES:
Job Description: We are seeking a dedicated Actuary to join our Actuarial Services team, focusing on Health Value Optimization. This role involves critical analysis and support of vendor contracts, ensuring these align with our strategic goals in health value optimization. The successful candidate will play a key role in influencing how our contracts contribute to the overall value and efficiency of healthcare delivery.

Key Responsibilities:
* Analyze and evaluate vendor contracts with a focus on Health Value Optimization, financial implications, and risk assessment.
* Apply advanced actuarial techniques to model and forecast the impact of vendor contracts on healthcare costs and quality.
* Collaborate with Provider Contracting, Vendor Management, and Clinical Care Innovation teams to ensure contracts support value-based care objectives.
* Lead the assessment of vendor proposals from a health value optimization perspective, ensuring alignment with company’s strategic goals.
* Contribute to the development and refinement of value-based and pay-for-performance models in vendor contracts.
* Provide actuarial insight in negotiations to maximize health value and cost-effectiveness of vendor agreements.
* Ensure compliance with relevant regulations and standards, particularly those related to value-based healthcare.
* Communicate complex actuarial analyses and strategies to internal and external stakeholders.

Qualifications:
* Bachelor’s degree in Actuarial Science, Mathematics, Statistics, or related field.
* Fellow or Associate of the Society of Actuaries (SOA) or similar professional body.
* Demonstrated experience in health insurance or related field, with a focus on health value optimization.
* Strong understanding of healthcare economics, value-based care, and vendor contract structures.
* Proficient in actuarial software and tools (e.g., SAS, SQL, R) and their application in health value analysis.
* Excellent analytical, negotiation, and communication skills, with the ability to articulate the value proposition of complex actuarial strategies.

Hybrid
Independence has implemented a “Hybrid” model which consists of Associates working in the office 3 days a week (Tuesday, Wednesday & Thursday) and remotely 2 days a week (Monday & Friday). This role is designated as a role that fits into the “Hybrid” model. While associates may work remotely on our designated remote days, the work must be performed in the Tri-State Area of Delaware, New Jersey or Pennsylvania.

Equal Employment Opportunity
Independence Blue Cross is an Equal Opportunity and Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.