Arcadia1mo ago

USD 160000–180000/yr

Sr. Manager, APM Modeling & Analytics

Remote (usa) · (usa)RemoteFull-time Remotesenior

Data ScienceOtherManager Apm Modeling & Analytics

0 views0 saves0 applied

Apply Now

Quick Summary

Overview

Arcadia is dedicated to happier, healthier days for all. We believe that there is a better healthcare world – one powered by data. Our platform transforms complex,

Technical Tools

Data ScienceOtherManager Apm Modeling & Analytics

Arcadia is dedicated to happier, healthier days for all. We believe that there is a better healthcare world – one powered by data. Our platform transforms complex, diverse data into a unified foundation for health, helping organizations deliver better care, boost revenue, and lower 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 arcadia.io

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.

This includes full accountability for:

CMS APM (e.g., LEAD, TEAM, ACCESS, MSSP) solution development and implementation

CMS data (e.g., VRDC, CCLF, BCDA) ingestion and execution

Independent validation and quality controls

This 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., SAS, Python, SQL), exceptional attention to detail in building and validating complex financial models at scale, and leadership in establishing and enforcing validation and quality assurance controls.

What Success Looks Like

In 3 months

Develop deep working knowledge of CMS LEAD model methodology and financial mechanics
Contribute to Arcadia’s market communications on the CMS LEAD model (e.g., whitepaper, customer discussions)
Gain hands-on access to VRDC data sources and Arcadia’s data ingestion processes
Understand existing Arcadia APM calculation logic and identify improvement opportunities
Establish coding standards and validation protocols for actuarial model governance

Develop CMS LEAD model financial calculations and underwriting framework in collaboration with actuaries
Fully own other existing Arcadia CMS APM solutions (e.g., MSSP)
Serve as the internal subject matter expert for CMS APM financial modeling
Build reproducible, well-documented SAS and Python pipelines for:
- Customer data ingestion
- Benchmark construction
- Risk score development and normalization
- Trend and PMPM projections
- Savings/loss simulations
Implement multi-layer QA processes and reconciliation procedures

Deliver production-ready, validated CMS LEAD model outputs to clients
Be recognized as Arcadia’s enterprise leader for APM financial modeling
Establish formal governance for underwriting 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

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

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

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

Listing Details

Posted: March 18, 2026
First seen: March 26, 2026
Last seen: April 22, 2026

Posting Health

Days active: 26
Repost count: 0
Trust Level: 51%
Scored at: April 22, 2026

Signal breakdown

freshnesssource trustcontent trustemployer trust

Apply for this position

Arcadia

lever

Arcadia is a healthcare technology company that transforms data into actionable insights to accelerate healthcare transformation for providers, payers, and life sciences organizations.

Employees

350

Founded

2002

Jobs

View 16 jobs

View company profile

Salary

USD 160000–180000

per year

Apply now

External application · ~5 min on Arcadia's site