Actuarial Analyst III

  • 36391
  • Health - Actuarial
  • |
  • Massachusetts, United States
  • |
  • Dec 5, 2019
  • Lead the rate development process by providing analyses and recommendation on benefit design, rating factors and projection of future claim cost.
  • Lead the reviews of the rate filings to Department of Insurance and the preparation of data for additional inquiry and requirements of the DOI.
  • Prepare analyses of regulatory mandate impacts on the projected claim cost.
  • Support in the preparation of risk adjustment analyses.
  • Participate in external and regulatory audits.
  • Lead the analyses and provides recommendation on reserves for various block of business.
  • Prepare monthly accruals and timely trend analyses for different block of business.
  • Lead in the analyses for financial forecasting, reforecast and other financial projections.
  • Responsible for ad-hoc analytics including modeling of benefit scenarios. Utilizes statistical applications as necessary.
  • Responsible for supporting corporate initiatives/projects that require analysis of health plan data.
  • Build financial and actuarial models and conduct statistical analyses such a risk sharing simulations.
  • Serve as data expert for department. Advises Finance department on data warehouse design, requests and works with IT to establish priorities.
  • Initiate and lead efforts to continually improve data quality and efficiency of various analyses and reporting.
  • Share knowledge and provide training to new employees.
  • Draw together various facts and inputs from various resources and summarizes and presents the information.
  • Reconcile and validate data from warehouse with Corporate Finance.
  • Develop Actuarial analysis concerning complex issues and understand different drivers of trends.
  • Maintain and build rating and financial forecasting models and ensure consistency and accuracy of the model.
  • Bachelor’s Degree in Mathematics, Actuarial Science, Finance, Economics or related field required.
  • Proficiency working with actuarial modeling, SAS and MS Excel.
  • Master’s Degree preferred.
  • Successful completion of at least 4 or more Actuarial exams preferred.
  • At least 3-4 years of progressively responsible experience in actuarial analysis, data modeling, informatics and analysis. Commensurate educational experience in related field will be considered.
  • A background in managed healthcare, insurance operations preferred.
  • An experienced user of claims and membership data.
  • Working knowledge of MS tools, including MS Office products, MS Access, MS Project, SQL and SAS or other statistical software. Should be proficient in Microsoft Excel.
  • Analyst integrates external grouping methodologies such as DRG, ETG and DxCG in analytics.
  • Ability to meet deadlines, multi-task, problem solve and use appropriate technology to analyze business problems. Project management skills a plus.
  • Ability to work collaboratively with other departments.
  • Strong communications skills, both verbal and written, are required.