Summary :
- Identify opportunities to reduce medical expenses and collaborate with other areas to implement and monitor performance.
- Participate in product development, pricing, filing, and rating implementation of new products and strategies.
- Develop studies, analyses, and presentation materials needed to appropriately inform decision makers,
- Answer questions of less experienced staff.
Responsibilities :
- Analyze and understand hospital, professional, and drug claim / utilization trends, membership / demographics, and financial variance to budget, and performs various other ad-hoc analyses.
- Maintain appropriate controls around models and other work products.
- Ensure quality and on time completion of deliverables.
- Provide support for coordination of quarterly close activities.
- Partner with key stakeholders to develop and finalize valuation methodologies.
- Prepare and analyze results and forecasts.
- Perform monitoring processes for trends and risk valuation calculations.
- Develop efficient and transparent queries to obtain data that is appropriate to the purpose with minimal assistance and oversight.
- Make appropriate recommendations to management across teams within the actuarial department.
- Proactively ensure the internal and external consistency of all work.
- Perform reasonability checks dependent on industry knowledge and experience.
- Develop and implement analyses for special projects.
- Provide technical and analytical support for both the Actuarial department and internal partners.
- Proactively take on additional work as needed by the team.
- Perform duties and assignments as directed or required.
Requirements :
- Bachelor’s degree in Actuarial Science, Mathematics, other physical science, or related finance / business degree required
- Associate of the Society of Actuaries preferred
- 4 - 6+ years of relevant, professional work experience and / or education required
- 1 - 2+ years health insurance actuarial experience, preferably in the managed care industry required
- Comprehensive understanding of actuarial principles and methodologies and strong mathematical and analytical skills required
- Excellent communication skills (verbal, written, presentation) required
- Strong working knowledge of MS Office including Outlook, Word, Excel, PowerPoint, etc. required
- Working knowledge of SQL, R, Python or similar required
- Capable with Excel, data extraction, simulations, automation required
- Knowledge of reimbursement methodologies required
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