JOB DESCRIPTION

The Senior Director - Actuary collaborates with stakeholders from across the organization and leads a team of directors and/or analysts to develop sophisticated risk management analytics that provide information, insights, and BI (Business Intelligence) solutions that contribute to sound strategic planning, risk assessment, decision-making, goal setting, and effective performance measurement. The Senior Director - Actuary will be a leader in the Managed Care and Population Health Analytics organizations and display a focus on the broad mission of MSHP to improve healthcare for our patients and providers in a financially sustainable manner.

RESPONSIBILITIES

• Partner with stakeholders from Managed Care and/or Population Health departments who will look to your expertise related to evaluating existing value-based contracts as well as assessing new value-based contract and partnership opportunities.

• Partner closely with finance to support contract negotiations, contracting reconciliations/settlements, financial modeling, forecasting and cost trend analyses of Managed Care and/or Population Health contracts, including the impact of clinical interventions on total cost of care.

• Develop medical economics-based reporting to identify opportunities to reduce the total cost of care for populations in our value-based contracts.

• Support annual strategic planning, budgeting, and business case development.

• Evaluate ongoing changes in payer contracts and government programs and make recommendations on appropriate actions for Mount Sinai.

• Stay abreast of industry trends and changes in healthcare regulations to inform strategic decision-making.

• Help develop staff to better understand population health, specialized risk arrangements, forecasting, financial modeling and performing analysis to inform business decisions.

• Analyze issues using enrollment, claims, clinical/EHR, medical management, financial and other corporate data from both modeled internal data as well as disparate internal and external sources. Also, help staff develop better analysis skills, understanding use cases and their value to the organization.

• Leverage advanced statistical analysis methods to create insightful recommendations and conclusions that you effectively communicate to your stakeholders.

• Clearly communicate data issues to the recipients and work to improve data quality where possible within the analytical models you create. Feed data quality issues back to IT or identified data stewards to assist in our quest for higher quality data.

• Develop and present reports, analyses and findings to senior management and others as scheduled or requested.

• Effectively communicates with stakeholders and customers and ensures all requests are properly triaged, recorded and tracked.

• Adheres to corporate standards for performance metrics, data collection, data integrity, query design, and reporting format to ensure high quality, meaningful analytic output.

• Develops and maintains project work plans, including critical tasks, milestones, timelines, interdependencies, and contingencies. Tracks and reports progress. Keeps stakeholders apprised of project status and implications for completion.

• Prepares clear, well-organized project-specific documentation, including, at a minimum, analytic methods used, key decision points and caveats, with sufficient detail to support comprehension and replication.

• Shares development and process knowledge with other managers and analysts to assure redundancy and continuously builds a core of analytical strength within the organization.

• Maintain Actuarial certification(s)

QUALIFICATIONS

• ASA/FSA Actuarial certification

• Bachelor?s degree in Actuarial Science, Math/Statistics, Economics, Finance, Computer Science or a related discipline; Masters or higher preferred

Experience Requirements

? At least ten (10) years of experience at a health plan, health provider, accountable care organization or in actuarial consulting required.

? FSA, PhD, MD or DO designation may be substituted for three (3) years of experience.

? Strong analytical skills, with the ability to perform complex analyses and modeling using a wide variety of statistical methods in support of standard actuarial analyses (forecasting, pricing, reserving, funding).

? At least three (3) years of experience in Medicare/Medicare Advantage and value-based care agreements with payers and/or employers.

? At least three (3) years of experience with medical economics analyses, including utilization and unit cost analyses of medical and pharmacy claims.

? At least three (3) years of experience with risk models, such as CMS HCC, Johns Hopkins ACG or other related products.

? At least three (3) years of experience formally or informally leading a team of actuaries or other data analysts.

? Strong data mining skills using tools like SQL, R, Python, etc.

? Strong working knowledge of Business Intelligence products (Tableau, PowerBI)

? Excellent oral and writing skills; ability to communicate effectively with varying audiences.

? Demonstrated ability to articulate goals, plan and implement processes to achieve those goals, recognize and assess the implications of confounding variables, and meet deadlines.

? Advanced interpersonal (e.g., mediating, mentoring, teaching) skills required to service internal and external clients effectively.

? Self-motivated with a demonstrated ability to work independently, and to exercise independent judgment in developing complex techniques or programs in a dynamic environment.

Additional Skills & Qualities

• Knowledge of the New York State Medicaid and CMS Medicare regulations and related reporting requirements, such as STARS, QARR, MMCOR, MEDS, RAPS and HEDIS is a strong plus

Licensing & Certification Requirements

• Associate or Fellow of the Society of Actuaries (SOA) Issuing Agency: SOA

General Skills & Competencies

1. Communication - Clearly conveying information and ideas through a variety of media to individuals or groups in a manner that engages the audience and helps them understand and retain the message.

2. Decision Making - Identifying and understanding issues, problems, and opportunities; comparing data from different sources to draw conclusions; using effective approaches for choosing a course of action or developing appropriate solutions; taking action that is consistent with available facts, constraints, and probable consequences.

3. Building a Successful Team - Using appropriate methods and a flexible interpersonal style to help build a cohesive team, facilitating the completion of team goals.

4. Adaptability - Maintaining effectiveness when experiencing major changes in work responsibilities or environment; adjusting effectively to work within new work structures, processes, requirements, or cultures.

5. Building Trust - Interacting with others in a way that gives them confidence in one?s intentions and those of the organization.

6. Aligning Performance for Success - Focusing and guiding others in accomplishing work objectives.

7. Customer Focus - Ensuring that the customer perspective is a driving force behind business decisions and activities; crafting and implementing service practices that meet customers? and own organization?s needs.

8. Driving for Results - Setting high goals for personal and group accomplishment; using measurement methods to monitor progress toward goals; tenaciously working to meet or exceed goals while deriving satisfaction from that achievement and continuous improvement.

9. Coaching and Developing Others - Providing feedback, instruction, and development guidance to help others excel in their current or future job responsibilities; planning and supporting the development of individual skills and abilities.

10. Building Partnerships - Identifying opportunities and taking action to build strategic relationships between one?s area and other areas, teams, departments, units, or organizations to help achieve business goals.

11. Delegating Responsibility - Allocating decision-making authority and/or task responsibility to appropriate others to maximize the organization?s and individuals? effectiveness.

12. Gaining Commitment - Using appropriate interpersonal styles and techniques to gain acceptance of ideas or plans; modifying one?s own behavior to accommodate tasks, situations, and individuals involved.

13. Stress Tolerance - Maintaining stable performance under pressure or opposition (such as time pressure or job ambiguity); handling stress in a manner that is acceptable to others and to the organization.

14. Compliance - Assures compliance with regulatory, insurance and ethical standards regarding safety of patients, employees, and property. Identifies contingency plans for potential risks.

Non-Bargaining Unit, E01 - Partner MSO Services - MSH, Mount Sinai Hospital

REQUIRED SKILLS

Microsoft Office Suite

ABOUT US

Strength Through Diversity

The Mount Sinai Health System believes that diversity, equity, and inclusion are key drivers for excellence. We share a common devotion to delivering exceptional patient care. When you join us, you become a part of Mount Sinai’s unrivaled record of achievement, education, and advancement as we revolutionize medicine together. We invite you to participate actively as a part of the Mount Sinai Health System team by:

• Using a lens of equity in all aspects of patient care delivery, education, and research to promote policies and practices to allow opportunities for all to thrive and reach their potential.

• Serving as a role model confronting racist, sexist, or other inappropriate actions by speaking up, challenging exclusionary organizational practices, and standing side-by-side in support of colleagues who experience discrimination.

• Inspiring and fostering an environment of anti-racist behaviors among and between departments and co-workers.

At Mount Sinai, our leaders strive to learn, empower others, and embrace change to further advance equity and improve the well-being of staff, patients, and the organization. We expect our leaders to embrace anti-racism, create a collaborative and respectful environment, and constructively disrupt the status quo to improve the system and enhance care for our patients. We work hard to create an inclusive, welcoming and nurturing work environment where all feel they are valued, belong and are able to advance professionally.

Explore more about this opportunity and how you can help us write a new chapter in our history!

“About the Mount Sinai Health System:

Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight hospitals, more than 400 outpatient practices, more than 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time — discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients’ medical and emotional needs at the center of all treatment. The Health System includes approximately 7,400 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics and top 20 in Cardiology/Heart Surgery, Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report’s “Best Children’s Hospitals” ranks Mount Sinai Kravis Children's Hospital among the country’s best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is ranked No. 14 nationwide in National Institutes of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek’s “The World’s Best Smart Hospitals” ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally.

The Mount Sinai Health System is an equal opportunity employer. We comply with applicable Federal civil rights laws and does not discriminate, exclude, or treat people differently on the basis of race, color, national origin, age, religion, disability, sex, sexual orientation, gender identity, or gender expression. We are passionately committed to addressing racism and its effects on our faculty, staff, students, trainees, patients, visitors, and the communities we serve. Our goal is for Mount Sinai to become an anti-racist health care and learning institution that intentionally addresses structural racism.”

EOE Minorities/Women/Disabled/Veterans

Requisition ID : 3017222