Large integrated healthcare delivery system looking for actuarial talent ideally with Medicare Advantage bid experience or ACA risk adjustment experience. Not a requirement, but a plus having this background. Organization provides medical and health services through a network, which includes regional clinics. Also provides health insurance services, ancillary health services as well as clinical research and education. Ideal applicant will have at least 2+ years of relevant actuarial experience and making good progress towards ASA designation, if not already an ASA. Job can possibly be remote, although being located in the Midwest is a plus.
PRIMARY RESPONSIBILITIES:
Evaluate and monitor rating formulas and factors for variances from expected. Recommend updates, including pricing benefit, trend, age/gender, and other rating factors. Lead maintenance of formulas and factors on rating engine system.
Update and maintain complex actuarial models, including pricing, reserving, and forecasting. Provide information on product level experience to finance and other management.
Working with team, prepare monthly reserve and variance analysis. Provide ad-hoc analysis of trends and variances. Prepare retrospective review of reserving method accuracy. Working with operations staff, develop new analysis input information.
Use actuarial and statistical concepts throughout assigned projects.
Provide training and feedback to departmental staff, including assisting others with the incorporation of actuarial concepts into their projects.
Conduct projects, and participate in team activities to identify problems and to improve work processes and systems, including data development.