Health First, Inc.
Description:\r \r To be fully engaged in providing Quality/No Harm, Customer Experience, and Stewardship by providing statistical data analysis/support and construct probability tables to forecast risk and liability. Support product rate filings, reserve calculations, group underwriting and experience reporting, to make price decisions. Support the financial management of the health plan through medical cost and revenue projections predominantly through the use of Excel. Explain complex technical matters as needed.\r \r \r Support and developed financial models for the monitoring and projection of current and future business.\r Maintain rating models and data base support programs used in the Underwriting department\r Develop and maintain models for the calculation of appropriate claims and other reserves.\r Submit weekly report showing progress on current projects\r Demonstrate dependability, flexibility and a high level of job interest.\r Consistently seek ways to improve operational and financial efficiencies through better use of resources.\r Contribute to development and maintenance of management reports necessary for the financial management of all products.\r Filing Support\\: support the development of required state and federal premium rates and other filings.\r Product Support\\: assist in development and pricing of new products and product enhancements. Collaborate with Decision Support, Underwriters, Claims, and Senior Management to develop plans for new lines of business or improve existing business.\r Financial Support\\: assist in the determination of cash reserves (IBNR), budget projections and all other financial modeling including development of provider payment mechanisms\r Group Services Support\\: support the design, review, administration, and regulatory compliance of health insurance plans in the delivery to specific employer groups.\r Underwriting Support\\: assist in development and pricing of existing and proposed Large Group business including support of pricing models.\r Qualification:\r \r BS or BA degree in Mathematics or Actuarial Science from accredited college or university.\r 3.4 GPA in college or university required.\r Possess strong computer abilities with emphasis on Microsoft Excel, SQL or other programming language desired.\r Passed one actuarial exam.\r Knowledge of laws, government regulations, and agency rules for managed care controls.\r Some level of understanding of insurance and associated terminology.\r Strong background in arithmetic, algebra, geometry, calculus, statistics, and their applications.\r Knowledge of economics and accounting principles and practices, and reporting of financial data.\r Knowledge of document structure and content, including spelling, grammar and rules of composition.\r Be able to perform support tasks under limited supervision by HF Actuary for at least one of the following responsibilities as described above\\: Filing, Financial, Group Services, or Underwriting.\r Has demonstrated an ability to work directly with Underwriting, Risk Adjustment, Finance, Decision Support, Group Services and/or Senior Management.\r Minimum of 6 months of experience in at least one of the following support responsibilities as described above\\: Filing, Financial, Product, Group Services, or Underwriting.\r
Health First, Inc.
Website : http://www.health-first.org
Health First also works together with other organizations and physicians in our community. Health First donates to the Brevard Health Alliance that provides healthcare services to thousands of underinsured or uninsured Brevard residents who are otherwise unable to pay for healthcare services. Our associates are also actively building a healthier community through volunteering for organizations dedicated to preventing and treating health concerns such as cancer, diabetes, and heart disease. We’re also proud of our associate's charitable giving plan, EAGLES (Every Associate’s Gift Leaves Everlasting Spirit), that promotes tissue and organ donor awareness, provides dental services for Brevard Health Alliance patients, and supports the Bright Star Center for Grieving Children & Families.The roots of Health First run deep in Brevard, dating back to 1937 when Brevard Hospital first opened in Melbourne with 27 beds. Now known as Holmes Regional Medical Center (HRMC), the hospital is Brevard’s largest, with 514 beds. Cape Canaveral Hospital (CCH) opened in 1962 with 44 beds, and has since grown to 150 beds. Palm Bay Hospital (PBH) opened in 1992 as a satellite of HRMC with 60 beds. Viera Hospital opened in 2011 with 84 all private, in-patient rooms. Health First was formed when CCH, HRMC, and PBH joined together in August 1995 to create a truly integrated not-for-profit healthcare delivery system and fulfill a common mission of improving the health of our community. The first new services added in the Health First family were Health First Medical Group, opening in late 1995, and Health First Health Plans, opening in January 1996. Since then, we’ve also added, Holmes Regional Trauma Center, VitalWatch- Central Florida's only electronic Intensive Care Unit, Viera Hospital, and many other services to our family.