Client looking to add an experienced Health Actuary to their staff. This role will be responsible for risk evaluation and management in support of strategies for profitable enrollment growth. Provides actuarial analysis and recommendations for decisions regarding benefit design, benefit pricing, network strategies, provider contracting, demographic risk selection and evaluation, risk adjustment, rate filings, and other business strategies. May be called upon to provide Statements of Actuarial Opinion. Work will include actuarial support for rate filings and work with small group, individual and family lines within ACA. Financial projections, risk adjustment around ACA, valuation and pricing and product development with regards to ACA. This role will also gain exposure to other areas within actuarial, so opportunity to gain broad exposure.
Ideal candidate will have:
Bachelors Degree along with at least 10 years of applicable healthcare experience.
FSA designation or very close in order to be considered.
SAS and/or SQL a bonus, but not required.
Pricing skill set preferred.
Manage client relationships with no supervision.
Demonstrated higher-order negotiation skills.
Expertise in financial and risk modeling.
Demonstrated ability to apply actuarial and underwriting principles in day-to-day problems.
Ability to develop and apply tactics to achieve organizational business strategy.
Ability to identify and solve problems.
Demonstrated working knowledge and skills in the analysis of health-care claims data and other related cost.
Demonstrated knowledge in analysis of member, purchaser, and provider contracting.
Excellent verbal, written and presentation communication skills.
Excellent customer service and organizational skills.
Demonstrated understanding of insurance principles.
Demonstrated working knowledge and skills in financial modeling.
Familiarity of financial transaction flow within operational and financial systems.
Proficient in Microsoft Office applications.