David Byron, Fsa, Maaa Email & Phone Number

Kirkland, Wa, Us

Seattle, Washington, United States

Responsibilities include:—Provider contracting and reimbursement—Network and ACO development—ACO risk management and financial forecasting—Value-based care—Analytic and reporting solutions

Greater Seattle Area

Provided strategic, financial and clinical risk advisory services and solutions for health systems, ACO's and providers.

Greater Seattle Area

Served as Lead Actuary for 4-6 client teams in West; Responsible for overseeing the financial analysis work of analysts, providing peer review, input with respect to methodology, assumptions setting, and final delivery to client; Presented financial reports (utilization, budgets, reforecasts, IBNP liability estimates, M&A healthcare valuations) to senior and executive level staff; Identified financial and utilization metrics to assess effectiveness of digital point solutions; Participated on pursuit teams including opportunity identification, strategy, serving as financial expert; Supervised professional development of 4-8 analysts and associates including workload management, coaching, and ongoing performance evaluation

Boston, Ma

Actuary and Manager, Product Development and PricingOversaw the development of actuarial analyses related to proposed, new and existing plan benefit designs; Evaluated financial viability of provider-focused products such as limited and tiered networks; Provided actuarial expertise to business partners including Product Development, Sales, Marketing, and Underwriting; Managed and developed multiple direct reports; Co-managed actuarial student program and responsible for annual budgeting, rotation oversight, program design, and coaching & development of junior actuaries;Associate ActuaryResearched, conceptualized and implemented a multiphase initiative to centralize analytics and core reporting processes; Modeled financial exposure of quality and efficiency measurements underlying risk-sharing arrangements with physician groups; Analyzed $4.1 billion in medical claims to inform strategies and support negotiations with hospitals; Demonstrated compliance of Medicare reimbursements made to hospitals; Measured impact of management’s pricing assumptions used in quarterly commercial HMO rate reviews and filings;Senior Actuarial AnalystDesigned clinical and financial benchmarks to assist in developing healthcare strategies for employers; Evaluated healthcare risks and illustrated savings opportunities;Earned recognition for conceptualizing and designing a high-cost-claimant reporting package;