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Sr. Manager, APM Modeling & Analytics

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The Muse

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Location:
United States

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Category:
IT - Software Development

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Contract Type:
Not provided

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Salary:

Not provided
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Job Description:

Arcadia is expanding its leadership in advanced alternative payment models (APMs), including CMS’ newly announced LEAD Model and other value-based initiatives. This role will report directly to the Chief Actuary, and serve as the enterprise owner 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.

Job Responsibility:

  • 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

Requirements:

  • 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

Nice to have:

  • Actuarial experience or experience supporting actuaries with CMS/CMMI Models (LEAD, TEAM, ACCESS, MSSP, etc.)
  • Consulting experience with deadline-driven project management accountability and effective communication of complex, technical topics to health plan or provider stakeholders
  • Hands on experience developing and overseeing product roadmap related to VRDC assets
What we offer:
  • Pet Insurance
  • Health Insurance
  • Dental Insurance
  • Vision Insurance
  • FSA
  • HSA
  • HSA With Employer Contribution
  • Life Insurance
  • Short-Term Disability
  • Long-Term Disability
  • Fitness Subsidies
  • Mental Health Benefits
  • Family Support Resources
  • Non-Birth Parent Or Paternity Leave
  • Adoption Leave
  • Fertility Benefits
  • Birth Parent Or Maternity Leave
  • Hybrid Work Opportunities
  • Flexible Work Hours
  • Remote Work Opportunities
  • Casual Dress
  • Pet-Friendly Office
  • Snacks
  • Company Outings
  • Commuter Benefits Program
  • Paid Vacation
  • Unlimited Paid Time Off
  • Paid Holidays
  • Personal/Sick Days
  • Leave Of Absence
  • 401(K) With Company Matching
  • 401(K)
  • Performance Bonus
  • Work Visa Sponsorship
  • Promote From Within
  • Access To Online Courses
  • Lunch And Learns
  • Diversity, Equity, And Inclusion Program
  • Employee Resource Groups (ERG)

Additional Information:

Job Posted:
April 02, 2026

Work Type:
Remote work
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