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
• 2 or more Actuarial exams completed and passed required
• 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
• Must make sufficient progress toward obtaining actuarial credentials, defined as sitting for a minimum of one exam per year, scoring above a zero, and obtaining at least a combined score of 5 over two consecutive sittings.
• When unable to meet the progress outlined in the bullet above, the role will be transitioned to a non-Actuarial job title and job description.
• 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