Fresenius Medical Care Holdings, Inc.
PURPOSE AND SCOPE:
Responsible for providing actuarial support for contracting with health plans, ACOs, ESCOs, C-SNPs and other risk arrangements. Performs actuarial analyses in support of pricing, reserving, provider contract development, and product development. Manages internal and external client workflows, as well as present technical materials to clients in an understandable way. Develops CMS required reserve amounts, monthly revenue and reserve estimates in support of financial reporting and work on MA bid submissions.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Performs assigned actuarial analyses tasks in support of pricing, reserving, provider contract development, and product development. This includes utilizing actuarial systems and programming skills to access and organize the data, performing the applicable actuarial calculations, analyzing moderate to complex information, assessing the reasonability of results and drawing conclusions, updating exhibits and slides, and completing documentation.
Performs research and collection of data, including data mining and reporting, which is provided to various customers inside and outside the department.
Develops CMS required reserve amounts and works on MA bid submissions.
Supports actuarial projects relating to complex issues and trends, coordinating with several different disciplines and staff.
Support efforts to continually improve data capabilities and quality of department analysis and reporting.
Assists in the development of pricing methodologies, analysis of the Plans risk pool and identification of trends in FMCs cost structure.
Requires an extensive understanding of the data available within the company, the health care market, applicable actuarial techniques, and changes in the health care legislation.
Review and comply with the Code of Business Conduct and all applicable company policies and procedures, local, state and federal laws and regulations.
Assist with various projects as assigned by direct supervisor.
Other duties as assigned.
Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions.
PHYSICAL DEMANDS AND WORKING CONDITIONS:
The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Bachelors Degree required with a focus in Mathematics, Statistics, Business, Health Care or related field strongly preferred.
ASA or progress towards ASA designation
EXPERIENCE AND REQUIRED SKILLS:
2 - 5 years related experience; or an advanced degree without experience; or equivalent directly related work experience.
Experience with Medicare Advantage and government programs is preferred.
Excellent communication skills are required.
Ability to draw together facts and input from a variety of sources and develop results.
Strong analytical skills and technical expertise.
Strong PC and software application experience.
Strong written and oral communication skills in a variety of settings.
Creative problem solving skills.
Advanced proficiency with Microsoft Office applications.
Experience with SQL, SAS or similar.
Excellent verbal and written communication skills.
Strong analytical skills.
Ability to prioritize work.
EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity
Enter your details to join Resume-Library and apply for this role
This email already exists
Enter your password to login and apply
Forgotten your password?
Fresenius Medical Care Holdings, Inc.
Website : http://www.freseniusmedicalcare.us/
Fresenius Medical Care is the leading network of dialysis facilities and top producer of dialysis equipment in North America and throughout the world, as well as a major supplier of renal pharmaceuticals. Through our more than 2,150 dialysis facilities in North America and our vascular access centers, labs, pharmacy, inpatient physicians, urgent care centers, affiliated hospitals and nephrology practices, we provide coordinated health care to hundreds of thousands of chronically ill people. Fresenius Medical Care North America is a division of Fresenius Medical Care (NYSE: FMS), the world's largest integrated provider of products and services for individuals undergoing dialysis because of chronic kidney failure, a condition that affects more than 2.1 million individuals worldwide.