A Health Plan Actuary Manager applies knowledge of mathematics, probability, statistics, and principles of
A Health Plan Actuary Manager applies knowledge of mathematics, probability, statistics, and principles of business to provide technical support for rating/pricing, valuation, reserving, healthcare economics, and/or financial forecasting. In this role, the actuary will build and test new actuarial models, assist with financial statements (including a Statement of Actuarial Opinion), and MLR calculations.
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Analyzing financial, statistical and mathematical data and performing actuarial calculations.
- Use SAS and SQL to create monthly reports to support trend reviews, pricing, forecasting, reserving, and value creation. Build in efficiencies to decrease run time.
- Consult with Tech team on how and what data should be accumulated
- Developing customized pricing and valuation models for the Curative Health Plan in an efficient, scalable, transparent, and accurate manner.
- Identifying and assessing risk in actuarial responsibilities.
- Creating reserving process and frequently monitoring to ensure reserve adequacy.
- Collaborating with Finance, Underwriting, Risk Management, and Sales/Marketing teams to ensure models are updated as needed to improve underwriting performance while maintaining adequate reserves.
- Providing actuarial support for internal and external reporting.
- Calculating IBNR/IBNP.
- Building of model enhancements and determines reasons for changes to calculated factors.
- Designing predictive modelling tools to determine focus of future Health Plan wellness and cost-saving initiatives.
- Supporting annual forecasting and budgeting efforts.
- Performing special projects as directed by management including actuarial research, experience studies, and statistical analyses and calculations as required.
QUALIFICATIONS To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions:
- Advanced analytical skills and creative problem-solving abilities with an attention to detail.
- Sound knowledge of actuarial techniques and standards.
- Able to translate and effectively communicate financial models and the results of actuarial analyses.
- Capable of working on multiple projects under tight deadlines.
- Excellent organizational and time management skills.
- Commercial awareness with an understanding of broader business issues.
EDUCATION and/or EXPERIENCE
- Minimum of five years of experience in actuarial work with a focus on pricing large group healthcare plans.
- Bachelor’s degree in actuarial science, math, statistics, finance, economics or related field required.
- ASA Designation Required. FSA Designation Preferred.
- Experience with all or part of Excel-based pricing model development and maintenance including VBA capabilities, SQL query development and data management, and predictive analytics. WORK ENVIRONMENT The 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.
- While performing the duties of this Job, the employee is regularly required to sit; use hands to handle or feel; talk; and hear.
- Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception and ability to adjust focus.
- The noise level in the work environment is usually: □ Mild
feel; talk; and hear.