Job Description:
The Manager, Valuation and Performance plays a highly critical, cross-functional role within our Finance team, ensuring the financial integrity, accuracy, and operational efficiency of our payer partnerships. The role will also partner with the the Executive Leadership Team (ELT), Accounting, Tech Org, Growth, Clinical Innovation, BOI Operations, and Markets.
In this role, you will own the end-to-end valuation of our risk-bearing contracts, focusing heavily on financial closes, IBNR accuracy, and complex payer reconciliations. You will serve as the primary bridge between our internal financial operations and our external payer partners, using advanced analytics and emerging AI capabilities to track performance, remediate contracts, and communicate vital financial trends to executive leadership.
Responsibilities
Financial Close & Actuarial Valuation
Lead Financial Closes: Drive the Valuation team’s contributions to Monthly, Quarterly, and Year-End audited financial close processes, ensuring accuracy and strict adherence to timelines.
Optimize IBNR Methodologies: Apply best-practice actuarial IBNR (Incurred But Not Reported) methodologies to establish internal best estimates for incurred claims, actively working to improve accuracy and significantly reduce volatility.
Payer Reconciliations & External Relations
Manage Payer Reconciliations: Take ownership of complex clinical exclusion reconciliations and risk-share settlement reconciliations with our payer partners.
Lead External Payer Communications: Manage external relationships with payer Actuaries and Finance Teams to align on performance metrics, resolve discrepancies, and finalize risk-share settlement issues.
Drive Contract Remediation: Perform internal deep-dive financial and actuarial analyses on existing partners to support and advance contract remediation outcomes with payers.
Performance Reporting & AI Innovation
Executive Reporting & Dashboards: Develop, implement, and maintain comprehensive dashboard and reporting solutions to highlight financial performance trends and insights for the broader Finance team and Executive Leadership Team (ELT).
Leverage AI for Process Improvement: Champion the use of AI capabilities and advanced automation to improve large-scale data processes, enhance actuarial trend reporting, and elevate the continuous performance monitoring of the business.
Requirements for the Role
Experience: 5+ years of experience in actuarial science, healthcare economics, or healthcare valuation, specifically within value-based care, Medicare Advantage, or Medicaid environments.
Education/Credentials: Bachelor’s degree in Actuarial Science, Mathematics, Finance, Economics, or a related quantitative field. ASA or FSA designation is highly preferred.
Technical Skills: Advanced proficiency in SQL, Excel, and BI/dashboarding tools (e.g., Tableau, PowerBI, Looker). Experience integrating AI or machine learning tools into financial/actuarial workflows is a strong plus.
Communication: Exceptional ability to translate complex actuarial and financial concepts into clear, actionable insights for non-technical stakeholders and ELT.
Relationship Management: Proven track record of managing external payer relationships, specifically interacting with partner actuaries and finance leaders during risk settlement and reconciliation processes.
We take into account an individual’s qualifications, skillset, and experience in determining final salary. This role is eligible for health insurance, life insurance, retirement benefits, participation in the company’s equity program, paid time off, including vacation and sick leave. The actual offer will be at the company’s sole discretion and determined by relevant business considerations, including the final candidate’s qualifications, years of experience, skillset, and geographic location. The expected salary range for this position is:
$110,000.00 - $145,000.00 AnnualCityblock values diversity as a core tenet of the work we do and the populations we serve. We are an equal opportunity employer, indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.
We do not accept unsolicited resumes from outside recruiters/placement agencies. Cityblock will not pay fees associated with resumes presented through unsolicited means.
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