Senior Actuary - Network Performance & Execution

This position within the Network Performance and Execution organization provides the financial tools and analytics to support network strategy in alignment with market/business growth priorities.This position provides a unique opportunity to experience the network buildout process from creation to implementation and performance evaluation as we are heavily involved in our expansion into the IFP market. The significant cross-functional collaboration required to build a network provides opportunities to gain insight into the complexity of one of our most valuable assets (our networks) and to broaden your scope and understand other critical areas across the company.The market-specific responsibilities will give them the opportunity to gain an in-depth knowledge of market dynamics and build strong cross-functional relationships with business partners (network, MEU, commercial actuarial, etc.). Other traditional areas of focus include network discounts, Accountable Care Organizations (ACOs), and other Value Based Contracts (VBCs).Network Actuary key responsibilities will include: • Provide support of the ACO and narrow network pricing for all Commercial market segments (IFP, Small, Select/Key, National, Public & Labor). This includes performing annual rate reviews in partnership with the Commercial Actuarial market actuaries for existing ACOs as well as participating in business development of new networks and ACOs.

• Monitor performance of existing networks and products to ensure adequate and competitive pricing that will support our Operating Plan goals for profitability and membership.
• Key partners are local network management, Commercial Actuarial, and MEU.