Own end-to-end financial modeling for CMS LEAD and other APMs
Translate CMS technical specifications into production-grade actuarial models
Develop and maintain benchmark, attribution, risk adjustment, and reconciliation logic
Ensure integrity of actuarial inputs (e.g., underwriting 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 SAS and Python code to:
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 integrity 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 all models at a sufficiently robust level to enable audits or CMS review

Bachelor's Degree in related Data Science, Actuarial Science, Finance, Economics or related 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 mindset
Experience modeling and evaluating key financial parameters within value-based contracts for health plan or provider
Experience with database querying (SAS, SQL, Python), Amazon Quick Site or BI Tool equivalent

Opportunity to lead Arcadia’s most high-profile client partnerships, influencing the direction of our actuarial strategy and product innovation
A seat at the table with Arcadia’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

Senior Manager, APM Modeling & Analytics

Key skills