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Actuarial Analyst--Healthcare

Location
Long Beach, CA

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Provide support for preparation of various monthly reports used for month-end close and IBNR calculations
Provide support to actuaries to perform monthly IBNR estimate by state
Document assumptions and analyzes results to identify early signs of trends or other issues related to medical care costs
Perform actuarial studies related to medical care costs and trends
Extract medical claim data from various systems, provide related financial analysis and identify trends to support executive decision-making
Collaborate with the other analysts to provide analytical support to the continued implementation and ongoing maintenance of the MedInsight system
Essential Functions:
Provide support for the development of the monthly IBNR estimates by state
Document assumptions
Analyze results to identify early signs of trends or other issues related to medical care costs
Perform actuarial studies related to medical care costs and trends, as assigned
Generate and distribute various routine reports to support month-end close, IBNR calculations, and Monthly Management Report package
Extract and compile various sources of information and large data sets from various systems to create Inpatient/Outpatient/Physician cost and utilization studies
Provide support for the development of reports and analysis for senior management pertaining to areas such as premium, membership, capitation, FFS claims, Encounter claims, pharmacy, authorizations, provider contracting and profitability; communicate analysis and supporting data in a manner that is meaningful to the recipient
Assist with gathering claim experience for Rate Development Template (experience data required by various states that is used by the state s actuary to develop rates) and State regulatory reports Assist with the development and ongoing production of executive reporting package derived from the MedInsight system
Prepare and maintain documentation for the production of standard reporting processes and procedures
Assist with report enhancements and modifications, coordinating with other team members as needed
Develop various ad-hoc reports as requested
Duties and Responsibilities:
Depending on the assignment within the Actuarial Department, may be required to perform one or more of the following:
Collaborate with the other analysts to provide analytical support to the continued implementation and ongoing maintenance of the MedInsight (decision support) system
Develop a good understanding of the derivation of the data elements captured by MedInsight and any assumptions underlying the reports
Assist with MedInsight data preparation and validation of regular refresh
Provide assistance for actuarial work for Medicare Advantage Plans including:
Bid development work
Extracting data from claims system for analysis
Developing and maintaining spreadsheets for comparison of actual versus planned claims experience, and developing and updating cost projections
Provide assistance for actuarial work for Medicaid Contracts including:
Pricing analysis for renewal of state contracts and for RFPs for new states
Data extraction for Medicaid members
Development and maintenance of spreadsheets for analyzing profitability of Medicaid members by line of business
Provide assistance for actuarial work for Health Insurance Exchange Offerings including:
Pricing analysis for renewal and new plan types
Data analysis and extrapolation for potential HIE coverage segments
Development and maintenance of spreadsheets for analyzing profitability of HIE members by plan type
Knowledge/Skills/Abilities:
Excellent verbal and written communication skills
Required Education:
Bachelor's Degree or Higher
Strongly prefer major in information systems or related quantitative field (finance, computer science or mathematics)
Required Experience:
Have some working knowledge of the managed healthcare business, data analysis experience in a healthcare setting
Must have strong math and analytical skills
Requires good working knowledge of Excel and relational databases/SQL Server
Ability to create and manage spreadsheets with ease
Strong understanding of financial concepts
Advanced financial and/or managed care/provider contract modeling experiences a plus
Effective oral, written and interpersonal communication skills are required
2-4 years of experience in related field
Required Licensure/Certification:
Must have passed at least 2 actuarial exams
- provided by Dice Excel, Relational databases, SQL Server, Managed healthcare knowledge, Must have passed at least two actuarial exams, MedInsight
Location
Long Beach, California, United States of America
Industry
IT
Start Date
Wed, 20 June 2018 19:00:00 EST
Rate
USD
Employment Agency
Summitech Consulting
Contact
Summitech Consulting
Reference
JSSUMITECH/E28A653E4D188C9B3CE2830A4E23D5D7/460283365
Posted Date
7/9/2018 9:46:20 PM
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