Senior Actuarial Analyst - Health 9468
SUMMARY: This position monitors claims trends and tracks provider risk scores to support risk adjustment analysis, and ongoing analysis and monitoring of utilization targets. The Sr. Actuarial Analyst assists in the development of provider rates as well as the ongoing review of rate adjustments and rate requests. The Sr. Actuarial Analyst helps to coordinate between external consultants and internal staff on periodical rate adjustment for clients. The Sr. Actuarial Analyst supports the RFP response process and the development of price forecasts. annual budget process and reviews work papers of other Finance staff as needed. The Sr. Actuarial Analyst will also provide ad hoc assistance to senior-level management as needed.
· Forecast and develop pricing methodologies, assumptions, new rates and cost estimates for contract negotiations.
· Develop and present sound rate recommendations to internal business leaders quarterly.
· Financial trend analysis through Sage Intacct KPI’s and internal InSight reports
· Economic analysis and impact studies originating from external sources
· Provide input on market strategy, including but not limited to competitive analyses, ad hoc actuarial studies, and other market-specific projects.
· Continual review of provider rates for all LOBs
· Support RFP pricing and review companywide provider rates quarterly.
· Corporate oversight of special rate usage and identifying areas of opportunities.
· Collect and compile statistical data and provide provides management with statistical findings and conclusions.
· Other duties may be assigned.
· Strong verbal and written communication skills
· Proficient knowledge in Microsoft Excel
· Strong Business acumen and analytical skills
· Must be Detail oriented, tactful, driven, responsive and a problem solver.
· Ability to communicate complex analytical results effectively.
· Ability to work independently and in a team environment.
· Ability to maintain confidential information.
MINIMUM REQUIRED EDUCATION:
· Bachelor’s degree in Actuarial Science, Finance, Statistics or related field.
· 5+ years healthcare, insurance actuary experience, or related field.
· Experience with Medical claims trends, forecasting and rate pricing preferred
· Society of Actuaries membership preferred.
· Experience leading teams and managing client/executive relationships.