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Overview

Vice President, Risk Management Jobs in Greenville, SC at Prisma Health

Title: Vice President, Risk Management

Company: Prisma Health

Location: Greenville, SC

Inspire health. Serve with compassion. Be the difference.

Job Summary In this role, you will be responsible for the build out and management of the enterprise’s risk management division, serving both the payer organization and broader health system. This division leader role will incapsulate the payer organization’s risk management strategy, which includes both internal and external teams and processes. The team will include a broad array of functional areas related to medical economics, actuarial sciences, underwriting, and analytics & reporting. This role will influence the enterprise’s payer strategy and serve as a key executive in both internal and external forums.

Accountabilities

Develop & execute a division-wide risk management strategy, informing the needed infrastructure, budget, and processes needed to successfully implement and operationalize a modern payer organization – 15%
Develop & manage the underwriting team, responsible for all applicable insurance products including the Medical Stop-Loss Captive – 15%
Develop & manage the actuary team, responsible for all applicable insurance products, as well as other related risk-based programs, including the enterprise’s value-based contracts and related VBC programs (ex. MSSP ACO) – 15%
Develop & manage the medical economics team, responsible for prospective and current client analysis related to clinical and Rx opportunity analysis, as well as applicable reporting and recurring analysis – 15%
Develop & manage the payer-organizations reporting, forecasting, & analytics team, informing internal stakeholders on needed analysis, as well as client reporting – 15%
Serve as an executive leader in the payer organization, infroming the enterprise’s payer and payer-related strategies – 10%
Maintain external partnerships related to any support function for risk management services (ex. external MGUs, Actuary Firms, etc.) – 10%
Serve as external senior-level SME for any interaction requiring domain expert in risk management – 5%

Supervisory/Management Responsibilities
Job has direct and/or indirect supervision of team members that may include final budget authority, hire/termination authority, performance appraisal responsibility and disciplinary authority. Job will be considered a member of management staff at Prisma Health or affiliate and will have direct reports.

Minimum Requirements

Bachelor’s Degree – Mathematics, Statistics, Actuary Sciences, Economics, Business Administration
10 years – Actuary, Medical Economics, Underwriting, Econometrics, Reporting & Analytics

Required Certifications, Registrations, Licenses

Group & Health Benefits from the Society of Actuaries

Knowledge, Skills or Abilities

Actuarial Sciences
Medical Economics – Preferred
Healthcare/Captive Underwriting – Preferred

Required Knowledge & Skills

Basic computer skills including word processing, spreadsheets, database and data entry
Knowledge of office equipment (fax/copier)
Mathematical skills

Work Shift Day (United States of America)

Location Prisma Health Corporate Office

Facility 7001 Corporate

Department 70019023 President’s Office

Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.

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About Prisma Health