Summary: This position reviews and models medical claims and membership data for financial reporting and projections. Duties also include applying predictive models, researching health care industry trends, and developing executive-level presentations.
Essential Job Functions
- Pursues self-development and effective relationships with others by sharing resources, information, and knowledge with coworkers and customers; listening, responding to, and seeking performance feedback; acknowledging strengths and weaknesses; assessing and responding to the needs of others; and adapting to and learning from change, difficulties, and feedback.
- Completes work assignments by applying up-to-date knowledge in subject area to meet deadlines; following procedures and policies and applying data, and resources to support projects or initiatives; collaborating with others, often cross-functionally, to solve business problems; supporting the completion of priorities, deadlines, and expectations; communicating progress and information; identifying and recommending ways to address improvement opportunities when possible; and escalating issues or risks as appropriate.
- Supports actuarial documentation by assisting with the preparation and review for accuracy of the actuarial portion of financial reports and tax returns, and responses to insurance regulations.
- Supports product line evaluations by assisting with analysis of product line financials, pricing, reserve, valuation, cash flow analysis; and documenting product line performance, risk, and assumptions used in product development.
- Assists with actuarial research by conducting literature reviews with limited direction on standards, assumptions, competition, and the legal and regulatory environment.
- Analyzes financial risks and opportunities by applying basic actuarial methods; collecting data; and assisting with interpreting actuarial analyses.
- Supports collaborations with peer-level business partners by translating actuarial constructs into non-technical explanations; and complying with the Actuarial Standards of Practice.
- Supports actuarial modeling by learning and using actuarial models; assisting with the application of alternative assumptions and forecasts using in-house models or actuarial software; and validating the data.
Minimum Required Education, Experience & Skills
- Bachelor’s degree in mathematics or related field.
- One to two (1 - 2) years actuarial experience, or equivalent work experience in a directly related field.
- Passed at least two (2) actuarial exams.
- Healthcare experience.
- Strong Microsoft Excel skills.
Preferred Education, Experience & Skills
- ASA credential
- Experience with financial reporting & IBNR/reserving.
- Experience with value-based care.
- SQL or similar software skills.
- PowerBI or Tableau skills.
Physical & Mental Requirements: (check all that apply)
☐ Required immunizations and vaccinations.
☐ Ability to lift upwards of 50 pounds.
☐ Ability to push or pull heavy objects using up to 100 pounds of force.
☐ Ability to stand or sit for extended periods of time.
☐ Ability to use fine motor skills to operate equipment and/or machinery.
☐ Ability to properly drive and operate a company vehicle.
☒ Ability to receive and comprehend instructions verbally and/or in writing.
☒ Ability to use logical reasoning for simple and complex problem solving.
☐ Occasionally requires exposure to communicable diseases or bodily fluids.
☐ Ability to discriminate shades of color when reading a dipstick.
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What We Do
InnovaCare Health improves the lives of members and physicians through innovative solutions for value-based healthcare. In each unique market the company serves, InnovaCare works across the healthcare ecosystem – with patients, providers, payers and other partners – to increase access to high-quality, affordable care.
Based in White Plains, N.Y., InnovaCare has been on the forefront of value-based care for more than a decade, distributing risk and developing proprietary technologies to inspire patient and provider engagement. Through an integrated portfolio of health plans, medical service organizations, clinical networks and more, the company manages more than 500,000 lives, including more than 150,000 dual-eligible beneficiaries. InnovaCare’s Medicare Advantage plans have received NCQA accreditation and 4.5-star quality ratings from the Centers for Medicare and Medicaid Services (CMS).
