Actuary

About the Company

Ennoble Care is a mobile primary care, palliative care, and hospice service provider. Their clinicians provide a continuum of care for patients with chronic conditions and limited mobility through programs like remote patient monitoring and chronic care management.

Responsibilities

• Analyze VBC performance under various CMS and CMMI total cost-of-care models
• Monitor and forecast financial performance across assigned patient populations
• Conduct comprehensive claims analysis using CCLF and BCDA datasets
• Refine key reporting and projection methodologies, including IBNR and Risk Score projections
• Develop and maintain SQL-based data structures to support population experience studies
• Create analytical reports and executive dashboards to translate findings into actionable insights
• Present findings and recommendations to leadership and clinical stakeholders
• Stay current with evolving CMS and CMMI program requirements

Requirements

• 5+ years of healthcare data analytics experience in Medicare or Medicare Advantage environments
• Thorough understanding of Medicare risk adjustment and CMS-HCC models
• Experience with CMS and CMMI total cost of care (ACO) programs
• Proven track record in claims analytics using Medicare claims data
• Advanced proficiency in Microsoft Excel and model building
• Strong SQL skills for writing complex queries
• Bachelor's degree in Actuarial Science, Statistics, Mathematics, Data Science, or a related quantitative field

Preferred Qualifications

• ASA credentials or passing at least the first three actuarial exams
• Experience with Microsoft Azure cloud platform
• Experience integrating EHR data with claims datasets
• Experience developing AI-forward workflows into analytics