Manager Actuarial Services at AmeriHealth Caritas (Philadelphia, PA)

| Philadelphia, PA
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This role is eligible for a $5,000 sign-on bonus

Manage a small team of analysts. Develop health care cost trend analytics as part of a dynamic team. Build, deploy and maintain dashboards and analyses that support identification of meaningful medical and pharmacy cost trends. Collaborate with subject matter experts to identify root causes of trends. Work with markets and corporate functions to identify potential medical cost containment initiatives to manage MLR and develop tracking tools to identify realized vs expected savings targets. Develop provider contracting tools and methodologies to support network teams - familiarity with value based contracts, risk sharing arrangements, traditional per case and per diem contract development preferred. Provides support to negotiations on reimbursement rates and provides data to support rate changes/adjustments in various markets. May work with multiple business segments and departments. The ideal candidate will have a thirst for continuous learning, investigative analytics, reporting, analysis and creative problem solving. He/she will be sought out as an expert on the projects they support, sharing work with a wide array of audiences. This is a great opportunity to utilize strong skills in programming, analytics and reporting.

Experience & Education:
  • Bachelor's Degree actuarial science, statistics or mathematics or business field required
  • FSA certification
  • 5 years working within a managed care organization, health insurer or as a consultant
  • 5-7 years claims analysis or cost reporting experience
  • 5 years working in / from a data warehouse environment
  • 5 years SAS or SQL programming experience
  • Experience using SAS Enterprise Guide
  • Experience developing Tableau Dashboard
  • Programming experience in Python and R a plus
  • Problem solving skills, including the ability to work independently and systematically analyze complex problems, draw relevant conclusions and successfully devise / implement solutions calmly and effectively
  • Advanced capabilities with MS Excel including VBA, Pivot tables and runninig queries proficiency with PowerPoint.
  • Establish ability to manage multiple initiatives, shifting back and forth effectively among activities to produce positive results in a dynamic environment
  • Excellent written and verbal communication skills, strong data presentation skills and solid understanding of relational database fundamentals
More Information on AmeriHealth Caritas
AmeriHealth Caritas operates in the Healthtech industry. The company is located in Philadelphia, PA, Newark, DE, Harrisburg, PA, Washington, DC and Southfield, MI. AmeriHealth Caritas was founded in 1983. It has 4500 total employees. It offers perks and benefits such as Flexible Spending Account (FSA), Disability insurance, Dental insurance, Vision insurance, Health insurance and Life insurance. To see all 8 open jobs at AmeriHealth Caritas, click here.
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