Vacancy expired!
Become a part of our caring community and help us put health firstThe 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.
In addition to being a great place to work, Humana also offers industry leading benefits for all employees, starting your FIRST day of employment. Benefits include:
Medical Benefits
Dental Benefits
Vision Benefits
Health Savings Accounts
Flex Spending Accounts
Life Insurance
401(k)
PTO including 8 paid holidays, one personal holiday, one day of volunteer time off, 23 days of annual PTO, parental leave, caregiving leave, and weekly well-being time
And more
Use your skills to make an impactRequired Qualifications
Bachelor's degree in Actuarial Science, Mathematics, Statistics, Finance, or other related field
1+ years actuarial experience, or progress in the Society of Actuaries (SOA) exam program
Experience modeling financial performance using healthcare claims data
Advanced knowledge in Microsoft Excel (ex. formulas, pivot tables, and graphs), PowerPoint, Word, Outlook
Advanced knowledge of SQL, SAS or equivalent language
Effective verbal and written communication and presentation skills appropriate for communication with both external clients and senior management
Preferred Qualifications
Experience in risk adjusted financial analysis and reporting for Value Based Health Care agreements
Data visualization (PowerBI/Tableau/Qlik)
Additional InformationThis position is Remote with EST hours.Work at Home/Remote RequirementsWork-At-Home Requirements
To ensure Home or Hybrid Home/Office associates' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office associates must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is recommended to support Humana applications, per associate.
Wireless, Wired Cable or DSL connection is suggested.
Satellite, cellular and microwave connection can be used only if they provide an optimal connection for associates. The use of these methods must be approved by leadership. (See Wireless, Wired Cable or DSL Connection in Exceptions, Section 7.0 in this policy.)
Humana will not pay for or reimburse Home or Hybrid Home/Office associates for any portion of the cost of their self-provided internet service, with the exception of associates who live or work from Home in the state of California, Illinois, Montana, or South Dakota. Associates 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 associates 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 ProcessAs part of our hiring process for this opportunity, we may contact you via text message and email to gather more information using a software platform called Modern Hire. Modern Hire Text, Scheduling and Video technologies allow you to interact with us at the time and location most convenient for you.If you are selected to move forward from your application prescreen, you may receive correspondence inviting you to participate in a pre-recorded Voice, Text Messaging and/or Video interview. Your recorded interview will be reviewed and you will subsequently be informed if you will be moving forward to next round of interviewsIf you have additional questions regarding this role posting and are an Internal Candidate, please send them to the Ask A Recruiter persona by visiting go/Buzz and searching Ask A Recruiter! Please be sure to provide the requisition number so we may be able to research your request quicker.This is a remote position.#LI-LM1#LI-RemoteScheduled Weekly Hours40Pay RangeThe 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 decisions will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.$65,000 - $89,500 per yearDescription of BenefitsHumana, 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 usHumana 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 EmployerIt 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.Humana complies with all applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, sex, sexual orientation, gender identity or religion. We also provide free language interpreter services. See our https://www.humana.com/legal/accessibility-resources?source=HumanaWebsite.
