Summary: This position reviews and models medical claims and membership data for financial reporting and projections. Duties also include applying predictive models, researching health care industry trends, and developing executive-level presentations.
Essential Job Functions
- Pursues self-development and effective relationships with others by sharing resources, information, and knowledge with coworkers and customers; listening, responding to, and seeking performance feedback; acknowledging strengths and weaknesses; assessing and responding to the needs of others; and adapting to and learning from change, difficulties, and feedback.
- Completes work assignments by applying up-to-date knowledge in subject area to meet deadlines; following procedures and policies and applying data, and resources to support projects or initiatives; collaborating with others, often cross-functionally, to solve business problems; supporting the completion of priorities, deadlines, and expectations; communicating progress and information; identifying and recommending ways to address improvement opportunities when possible; and escalating issues or risks as appropriate.
- Supports actuarial documentation by assisting with the preparation and review for accuracy of the actuarial portion of financial reports and tax returns, and responses to insurance regulations.
- Supports product line evaluations by assisting with analysis of product line financials, pricing, reserve, valuation, cash flow analysis; and documenting product line performance, risk, and assumptions used in product development.
- Assists with actuarial research by conducting literature reviews with limited direction on standards, assumptions, competition, and the legal and regulatory environment.
- Analyzes financial risks and opportunities by applying basic actuarial methods; collecting data; and assisting with interpreting actuarial analyses.
- Supports collaborations with peer-level business partners by translating actuarial constructs into non-technical explanations; and complying with the Actuarial Standards of Practice.
- Supports actuarial modeling by learning and using actuarial models; assisting with the application of alternative assumptions and forecasts using in-house models or actuarial software; and validating the data.
Minimum Required Education, Experience & Skills
- Bachelor’s degree in mathematics or related field.
- One to two (1 - 2) years actuarial experience, or equivalent work experience in a directly related field.
- Passed at least two (2) actuarial exams.
- Healthcare experience.
- Strong Microsoft Excel skills.
Preferred Education, Experience & Skills
- ASA credential
- Experience with financial reporting & IBNR/reserving.
- Experience with value-based care.
- SQL or similar software skills.
- PowerBI or Tableau skills.
Physical & Mental Requirements: (check all that apply)
☐ Required immunizations and vaccinations.
☐ Ability to lift upwards of 50 pounds.
☐ Ability to push or pull heavy objects using up to 100 pounds of force.
☐ Ability to stand or sit for extended periods of time.
☐ Ability to use fine motor skills to operate equipment and/or machinery.
☐ Ability to properly drive and operate a company vehicle.
☒ Ability to receive and comprehend instructions verbally and/or in writing.
☒ Ability to use logical reasoning for simple and complex problem solving.
☐ Occasionally requires exposure to communicable diseases or bodily fluids.
☐ Ability to discriminate shades of color when reading a dipstick.
