Actuarial Analyst 3

  • 37033
  • Health - Actuarial
  • |
  • Oregon, United States
  • |
  • Mar 13, 2020
Insurance
RESPONSIBILITIES
  • In consultation with outside actuaries, prepare annual Medicare bid or rate proposal and prepares the documents and analysis required for the annual Statement of Actuarial Opinion.
  • Use statistical and mathematical tools to solve business problems.
  • Work on core actuarial functions: Pricing, Reserving and Forecasting.
  • Develop solutions to quantitative problems.
  • Provides advanced analytic and statistical support for quality, clinical, and operational improvement activities. Also provides advanced analytical support for Finance, Provider Contracting, Product Development, and Medical Coding Administration. Includes effectively summarizing complex information into appropriate charts, tables, and figures in order to convey the meaning of the data to customers and decision-makers.
  • Provides expertise to responding to RFPs from existing and prospective employer groups using innovative analytical skills.
  • Analyze and develop unit costs for various payment methodologies, including capitation, RBRVS, per diems, DRGs, risk adjusted episodes of care and other payment innovation methods.
  • Accumulates source data and makes calculations to estimate Incurred but Not Reported claims expense and recommends alternative estimates.
  • Prepare reports for provider contract reconciliations and an estimate of the plan's provider incentive liability.
  • Prepare financial analysis for new products, product lines, and new service areas.
QUALIFICATIONS
  • Bachelor's Degree in a highly quantitative field plus a minimum of 7 years of experience in data analysis or equivalent education/experience.
  • Preferred:
  • Master's Degree.
  • Healthcare organization/health insurer experience.
  • Passed 3 SOA exams toward the ASA designation.
  • Experience preparing ACA Rate Filings.