Actuarial Analsyt -- Health-9059
Description
Getting close to your credentials? Looking for an environment that offers a diverse workload? Our client is seeking top talent to join a health actuarial rotational program. Qualified candidates should be making strong exam progress towards credentials. ASA is a plus.
Will perform semi routine actuarial and statistical analyses to estimate financial outcomes. Apply knowledge of mathematics, probability, statistics, and principles of business to complete health calculations. Program consists of 3 main areas:
Pricing (Commercial or Medicare)
• Prepares data for pricing research, including experience and trend analyses, book of business studies, CMS revenue and risk score analysis, etc.
• Prepares rating information packages to be delivered to underwriting and other internal customers.
• Prepares rate filings for State Insurance Departments, CMS and other regulatory agencies.
• Prepares and gathers the information necessary for special projects such as demographic factors, competitive analysis and other, as required.
• Performs other duties and special projects as required.
Medical Cost Analysis
• Prepares analysis and monitors claims trends for each line of business. Segregates cost, utilization, mix of services, coverage types and effects of benefit and demographic changes.
• Prepares reports of medical cost results, both historical and projected.
• Supports the valuation of medical cost initiatives and tracking of performance against goals.
• Supports the development of trend projections.
• Performs other duties and special projects as required.
Reserving/Planning
• Develops, calculates and monitors accruals, liabilities and reserves for lines of business assigned. Works with the actuary or management to ensure proper formulae are developed and applied.
• Develops interim estimates of refund liabilities for large accounts and accounts on alternative financial arrangements. May coordinate with Finance and Rating/ Underwriting departments to ensure that ratings methodologies are properly projected and accrued.
• Develops and calculates reserves for new products. Incorporates settlement terms as contained in various filings, agreements with accounts.
• Compiles data to support monthly financial forecasts of premium and claims.
• May assist with preparing the actuarial portions of financial statements and federal income tax returns and compiles, evaluates and certifies statistical data.
• Performs other duties and special projects as required