Actuarial Analyst — Health – 9416

Actuarial Analyst -- Health - 9416

Published: March 24, 2022
Philadelphia, PA
Job Type
Job ID
Yrs Exp(min)
4+ Exams
Salary (Mid)
Bill Riha
Recruiter Phone Number
800 543-2553 Ext. 105


The Actuarial Analyst II performs semi-routine actuarial and statistical analyses to estimate financial outcomes. Applies knowledge of mathematics, probability, statistics, and principles of business to complete health calculations.
Pricing (Commercial or Medicare):
1. Prepares data for pricing research, including experience and trend analyses, book of business studies, CMS revenue and risk score analysis, etc.
2. Prepares rating information packages to be delivered to underwriting and other internal customers.
3. Prepares rate filings for State Insurance Departments, CMS and other regulatory agencies.
4. Prepares and gathers the information necessary for special projects such as demographic factors, competitive analysis and other, as required.
5. Performs other duties and special projects as required.
Medical Cost Analysis:
1. Prepares analysis and monitors claims trends for each line of business. Segregate’s cost, utilization, mix of services, coverage types and effects of benefit and demographic changes.
2. Prepares reports of medical cost results, both historical and projected.
3. Supports the valuation of medical cost initiatives and tracking of performance against goals.
4. Supports the development of trend projections.
5. Performs other duties and special projects as required.
1. 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.
2. 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.
3. Develops and calculates reserves for new products. Incorporates settlement terms as contained in various
filings, agreements with accounts.
4. Compiles data to support monthly financial forecasts of premium and claims.
5. May assist with preparing the actuarial portions of financial statements and federal income tax returns and
compiles, evaluates and certifies statistical data.
6. Performs other duties and special projects as required.
· Bachelors degree in Mathematics, Statistics, Economics, Actuarial Services, or related field or equivalent work experience.
· Completion of actuarial course exams P, FM, IFM, LTAM and associated VEE credits, and a minimum of two years of experience is required.
· Solid mathematical background including experience working with risk models, actuarial or mathematical analysis, and using automated or statistical analysis tools, proficiency in Excel required.
· Knowledge of SQL server a plus. Excellent organizational, analytical, and communication skills required.

To apply please email: Bill Riha | 800 543-2553 Ext. 105
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