Senior Actuarial Analyst - REMOTE - Health - 9577
Client looking to add a Sr. Actuarial Analyst to their organization. Will support healthcare actuarial analyses under the supervision of senior actuarial staff. The position will either have knowledge of or will become knowledgeable in deploying value-based payment models, analyzing healthcare costs and trends, evaluating initiatives to reduce healthcare expense and other health care (Medicare, Medicaid, ACO REACH and Commercial) data analytics. Team members in this role are focused on either value-based care pricing or on cost of care initiatives. For the pricing role: Responsible for developing value-based pricing methodologies and models and conducting pricing analysis in support of organization's health product portfolio and VBC strategy, including:
Developing pricing methodologies and models to support the analysis of new business strategies including VBC arrangements with payers and providers.
Support the preparation of the product pricing, including the identification and quantification of financial risks and opportunities.
Quantify operational metrics that could impact the outcome of key pricing assumptions. For the cost of care role: Responsible for developing healthcare cost and utilization trend models, reporting macro-level changes and micro-level drivers, and estimating the savings impact of targeted initiatives, including:
Developing methodologies, models and conduct studies to support cost of care and trend analysis.
Utilizing various grouper methodologies to enhance data, analytic and reporting capabilities.
Supporting the organizations trend benchmarking initiatives and monitoring of cost of care targets.
Review, interpret and analyze data from multiple sources to determine impacts and needed actions.
Collaborates with management and supporting teams to ensure strong execution, delivery of customer value and positive business results.
With some supervision, complete timely and accurate analysis including the development of new models, processes and reports.
Supports the development of presentations which enables communication of analysis, results and observations.
Develop and support the maintenance of team documentation.
Develop and support the maintenance of the technical infrastructure that supports the team’s functions.
Be proactive in enhancing the teams modeling approach through process improvement, methodological enhancement, streamlining of tools, reporting, and analytics.
Brings forward issues to develop a plan of action. Identifies opportunities to improve processes and practices.
Supports evaluating financial and operational results, monitoring data and contributing to the development of key initiatives.
Looking for at least two years' experience in the healthcare insurance industry working across functions including finance, network, strategy and execution.
Progress towards Associate of the Society of Actuaries (ASA) designation
Possess skills to calculate and quantify potential risk using calculus, probability, and statistical analysis
Experience in applying analytic skills to sort and identify trends with massive amounts of data in order to make financial recommendations
Experience identifying operational issues and recommending and implementing strategies to resolve issues and problems.