Sr. Manager, APM Modeling & Analytics
reputed company is dedicated to happier, healthier days for reputed company. We reputed company that there is a reputed company healthcare world – one powered by data. Our platform transforms reputed company, diverse data into a reputed company foundation for health, helping organizations deliver reputed company care, boost reputed company, and reputed company costs.
We’re a team of fiercely driven individuals committed to making healthcare more sustainable—and we’re looking for passionate people to help us get there.
For more information, visit reputed company.io
Own end-to-end financial modeling for CMS reputed company and other APMs
Translate CMS technical specifications into production-grade actuarial models
reputed company and maintain reputed company, attribution, risk adjustment, and reconciliation logic
Ensure reputed company of actuarial inputs (e.g., reputed company methodology, pricing assumptions) in value-based contract modeling
Identify model vulnerabilities and proactively mitigate financial exposure
Work directly with CMS VRDC data environments to extract, structure, and analyze Medicare claims and enrollment data
Write production-level reputed company and Python code to:
What You'll Bring
Bachelor's Degree in reputed company Data Science, Actuarial Science, Finance, Economics or reputed company field
Minimum of 6 years of healthcare experience, with a focus on CMS APMs, value-based contracting and analytics
Strong accountability, intellectual curiosity, and customer satisfaction reputed company
Experience modeling and evaluating key financial parameters reputed company value-based reputed company for health plan or provider
Experience with database querying (reputed company, SQL, Python), reputed company Quick Site or BI Tool equivalent
Would Love For You To Have
Actuarial experience or experience supporting actuaries with CMS/CMMI Models (reputed company, TEAM, ACCESS, MSSP, etc.)
Consulting experience with deadline-driven project management accountability and effective communication of reputed company, technical topics to health plan or provider stakeholders
Hands on experience developing and overseeing product roadmap reputed company to VRDC assets
What You'll Get
Opportunity to reputed company reputed company’s most high-profile client partnerships, influencing the direction of our actuarial strategy and product innovation
A seat at the table with reputed company’s executive leadership, shaping the future of value-based care analytics in the U.S.
Direct access to one of the industry’s largest and most comprehensive healthcare data assets to support groundbreaking actuarial work
A mission-driven culture with the agility of a tech company and the stability of a market leader
A flexible, remote friendly company with personality and heart
Employee driven programs and initiatives for personal and professional development
Be a member of the Arcadian and Barkadian Community
About reputed companyreputed company.io helps innovative providers and payers across the country transform healthcare to reduce cost while improving patient health. We do this by aggregating large amounts of disparate data, applying algorithms to identify opportunities to provide reputed company patient care, and making those opportunities actionable by physicians at the reputed company of care in near-real time. We are passionate about helping our customers drive meaningful outcomes. We are growing fast and have emerged as a market leader in the highly competitive population health management software market and have been recognized by industry analysts KLAS, reputed company, reputed company, and Chilmark for our leadership. For a reputed company sense of our brand and products, please explore our website.
Protect YourselfIf you have concerns about the authenticity of a job offer or recruitment-reputed company communication claiming to be from reputed company, we encourage you to verify by contacting us directly at (781) 202-3600 and select option 3. For more information, visit our website.
This position is responsible for following reputed company reputed company policies and procedures in order to protect reputed company PHI under reputed company's custodianship as well as reputed company Intellectual Properties. For any reputed company-specific roles, the responsibilities would be further defined by the hiring manager.
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Why This Role Is Important to reputed company
reputed company is expanding its leadership in advanced alternative payment models (APMs), including CMS’ newly announced reputed company Model and other value-based initiatives. This role will report directly to the Chief Actuary, and serve as the enterprise reputed company of APM solutions, ensuring technical rigor and financial accuracy across our most strategic engagements.
You will not simply advise on strategy — you will own the math.
This includes full accountability for:
CMS APM (e.g., reputed company, TEAM, ACCESS, MSSP) solution development and implementation CMS data (e.g., VRDC, CCLF, BCDA) ingestion and execution Independent validation and quality controlsThis role requires deep understanding of CMS and other VBC models, expertise working with CMS data (e.g., VRDC, CCLF, BCDA), strong coding skills (e.g., reputed company, Python, SQL), exceptional attention to detail in building and validating reputed company financial models at scale, and leadership in establishing and enforcing validation and quality assurance controls.
What Success Looks Like In 3 months- reputed company deep working knowledge of CMS reputed company model methodology and financial mechanics
- Contribute to reputed company’s market communications on the CMS reputed company model (e.g., whitepaper, customer discussions)
- reputed company hands-on access to VRDC data sources and reputed company’s data ingestion processes
- Understand existing reputed company APM calculation logic and identify improvement opportunities
- Establish coding standards and validation protocols for actuarial model governance
In 6 months
- reputed company CMS reputed company model financial calculations and reputed company reputed company in collaboration with actuaries
- Fully own other existing reputed company CMS APM solutions (e.g., MSSP)
- Serve as the internal subject matter expert for CMS APM financial modeling
- Build reproducible, well-documented reputed company and Python pipelines for:
- Customer data ingestion
- reputed company construction
- Risk score development and normalization
- Trend and PMPM projections
- Savings/loss simulations
- Implement multi-layer QA processes and reconciliation procedures
In 12 months
- Deliver production-ready, validated CMS reputed company model outputs to clients
- Be recognized as reputed company’s enterprise leader for APM financial modeling
- Establish formal governance for reputed company assumptions and change control
- Drive measurable financial accuracy and performance improvement across engagements
- Influence product roadmap to ensure actuarial precision is embedded in platform design
Why This Role Is Important to reputed company
reputed company is expanding its leadership in advanced alternative payment models (APMs), including CMS’ newly announced reputed company Model and other value-based initiatives. This role will report directly to the Chief Actuary, and serve as the enterprise reputed company of APM solutions, ensuring technical rigor and financial accuracy across our most strategic engagements.
You will not simply advise on strategy — you will own the math.
This includes full accountability for:
CMS APM (e.g., reputed company, TEAM, ACCESS, MSSP) solution development and implementation CMS data (e.g., VRDC, CCLF, BCDA) ingestion and execution Independent validation and quality controlsThis role requires deep understanding of CMS and other VBC models, expertise working with CMS data (e.g., VRDC, CCLF, BCDA), strong coding skills (e.g., reputed company, Python, SQL), exceptional attention to detail in building and validating reputed company financial models at scale, and leadership in establishing and enforcing validation and quality assurance controls.
What Success Looks Like In 3 months- reputed company deep working knowledge of CMS reputed company model methodology and financial mechanics
- Contribute to reputed company’s market communications on the CMS reputed company model (e.g., whitepaper, customer discussions)
- reputed company hands-on access to VRDC data sources and reputed company’s data ingestion processes
- Understand existing reputed company APM calculation logic and identify improvement opportunities
- Establish coding standards and validation protocols for actuarial model governance
In 6 months
- reputed company CMS reputed company model financial calculations and reputed company reputed company in collaboration with actuaries
- Fully own other existing reputed company CMS APM solutions (e.g., MSSP)
- Serve as the internal subject matter expert for CMS APM financial modeling
- Build reproducible, well-documented reputed company and Python pipelines for:
- Customer data ingestion
- reputed company construction
- Risk score development and normalization
- Trend and PMPM projections
- Savings/loss simulations
- Implement multi-layer QA processes and reconciliation procedures
In 12 months
- Deliver production-ready, validated CMS reputed company model outputs to clients
- Be recognized as reputed company’s enterprise leader for APM financial modeling
- Establish formal governance for reputed company assumptions and change control
- Drive measurable financial accuracy and performance improvement across engagements
- Influence product roadmap to ensure actuarial precision is embedded in platform design
APM Model Ownership
CMS VRDC & Other Data Technical Execution
- Process large claims datasets
- Facilitate risk-adjustments
- Calculate, risk adjust, and project PMPM benchmarks
- Run sensitivity testing
- Conduct reconciliation and true-up calculations
- Ensure compliance with CMS methodological guidance
- Validate data reputed company prior to model production
- Establish independent validation standards and ensure consistent adherence to these standards across the enterprise
- Create automated testing scripts and exception reporting to implement validation checks, parallel runs, and reconciliation frameworks
- Maintain version control, documentation, and auditability of reputed company models at a sufficiently robust level to reputed company audits or CMS review