Actuarial Leader -Health - 9693
This leader will be responsible for mentoring and leading a team of analysts and will report to a Senior Actuary. The leader will be responsible for developing and supporting robust medical and pharmacy trend analytics to identify cost drivers for both management reporting as well as for actionable intervention working collaboratively with Medical Management and Network. The leader will be responsible for analytical support to Network Strategy, Network Relations, and Vendor Management for all contract negotiations as well as quantification of regulatory changes and / or strategic changes to provider payment rates or methodologies. This Leader will be work effectively across the organization as well as externally, communicate effectively and be able to draw insights from the data and propose solutions.
- Ability to persuade with data and communicate technical information effectively both verbally and via presentation
- In depth knowledge of Health care data including provider billing, coding, and reimbursement methods
- Strong analytical skills with detailed knowledge of Health Insurance products and claim data
- Advanced excel skills and basic knowledge of SQL and willingness to learn languages needed to advance capabilities
- Strong planning skills with the ability to effectively prioritize of tasks, projects, etc. in a dynamic environment.
- 3+ years working in health care related field
- ASA or near ASA
- Prior supervisor experience or experience as team lead