Actuarial Business Consultant

2 months ago

Hanover, United States Elevance Health Full time
Anticipated End Date:
2024-08-26

Position Title:
Actuarial Business Consultant - Risk Adjustment

Job Description:

Location: This position will work a hybrid model (remote and office). The Ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.

Preferred Location: Hanover, MD.

The Actuarial Business Consultant will complete the most diverse and complicated projects and performs highly complex actuarial studies.

How you will make an impact:
  • Insources Medicare Advantage Risk Adjustment Analytics from vendors.
  • Performs key actuarial functions including new product pricing, evaluation of the impact of new legislation, flexible benefit consulting, and special projects.
  • Designs and completes special projects such as developing and maintaining experience-rating formulae and creating and/or reviewing alternative settlement formulate and risk sharing models.
  • Responsible for recommendations on pricing, marketing, product design, claims, premium and enrollment administration of business unit.
  • Responsible for valuation support for business unit by interpreting financial results, variances from forecast to help identify product and segment behavior to assist in the risk management of the business unit.


Minimum requirements:

Requires a BA/BS in Mathematics, Statistics or related field and minimum of 8 years related experience in an actuarial environment performing financial reporting, rate development, evaluation of risk contingencies and/or trend projections; or any combination of education and experience, which would provide an equivalent background.

Preferred skills, capabilities, and experiences:

Medicare Advantage and/or Medicaid Risk Adjustment experience is strongly preferred.

Job Level:
Non-Management Exempt

Workshift:
1st Shift (United States of America)

Job Family:
ACT > Business Analysis

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer, and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.

  • Director of Medicare Advantage Product Development

    1 month ago

    Hanover, United States Johns Hopkins Health Plans Full time

    Job SummaryThe Director of Medicare Advantage Product Development for Johns Hopkins HealthCare will lead the development for growth and product strategies for the Medicare Advantage lines of business. Role Accountabilities Include:Responsible for product/benefit strategies, competitive analysis, state and federal regulatory filings, benefit design, and...

  • Field Sales Consultant

    1 week ago

    Hanover, Massachusetts, United States FASTSIGNS #311401 Full time

    Job OverviewWe are seeking a dedicated Field Sales Consultant to become a vital part of our dynamic team at FASTSIGNS #311401, a leader in the signage and graphics industry. This role offers an exciting opportunity to engage with a diverse range of businesses, providing them with innovative solutions that enhance their visibility and communication.Key...

  • Director of Medicare Advantage Product Development

    1 month ago

    Hanover, United States Johns Hopkins Medicine Full time

    Job Summary The Director of Medicare Advantage Product Development for Johns Hopkins HealthCare will lead the development for growth and product strategies for the Medicare Advantage lines of business. Role Accountabilities Include: Responsible for product/benefit strategies, competitive analysis, state and federal regulatory filings, benefit design, and...

  • Senior Tax Consultant

    2 weeks ago

    Hanover, Pennsylvania, United States Smith Elliott Kearns & Company LLC Full time

    Job OverviewWe are looking for a knowledgeable and motivated Senior Tax Consultant to become a key member of our team at Smith Elliott Kearns & Company LLC. In this role, you will be responsible for managing tax strategy and compliance activities, delivering expert advice to clients, and guiding a team of tax professionals. The ideal candidate will possess a...

  • Project Coordinator

    4 weeks ago

    Hanover, United States Dexian Full time

    Job Title : Administrative Project Coordinator - Medical AffairsLocation: Hanover, NJDuration: 12+ monthsPay range : $40-44/hr Purpose: Role is responsible for the coordination and planning of all MA Americas department events, projects and initiatives as well as administrative support for the Head of MA Americas. This role also serves as the Administrative...

  • Financial Consultant

    2 weeks ago

    Hanover, New Hampshire, United States Carson Group Holdings, LLC Full time

    Job OverviewAbout UsIn a world that is becoming increasingly intricate, we prioritize trust and integrity. Our mission is straightforward: always prioritize the client. We believe in the principle of doing well by doing good for those we assist. This is our ultimate benchmark. We are committed to delivering undeniable value and recognize that time will...

  • Business Development Executive

    3 weeks ago

    Hanover, United States Allegis Global Solutions Full time

    Job DescriptionJob DescriptionCompany DescriptionWorking at Allegis Global Solutions (AGS) is more than just a job. It’s a career. It’s a community of people who invest in your development and empower you to blaze your own trail. Each of us is here to create real, measurable impact that moves needles. We operate beyond "roles" or "jobs" to realize the...

  • Enterprise Sales Consultant

    2 weeks ago

    Hanover, Pennsylvania, United States BrightSpeed Full time

    Company Overview At Brightspeed, we are transforming the way individuals connect, work, and engage by delivering swift and dependable internet services alongside an exceptional customer experience across numerous states in the Midwest and South. Supported by investment from Apollo Global Management, our mission is to expedite the transition from copper to...

  • Group Underwriting Consultant, Senior

    1 month ago

    Hanover, United States Elevance Health Full time

    Elevance Health Group Underwriting Consultant, Senior HANOVER , Maryland Apply Now Location: Elevance Health operates in a Hybrid Workforce Strategy, providing various levels of flexibility while also ensuring that associates have opportunities to connect in-person. Unless in a designated virtual-eligible role and specified as primarily virtual by the hiring...

  • Network Relations Consultant

    2 weeks ago

    Hanover, United States Johns Hopkins Medicine Full time

    Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. YOU belong here. What awaits you: Work-life balance - This is a remote role! Medical, Dental, and Vision Insurance. 403B...

  • Network Relations Consultant

    3 weeks ago

    Hanover, United States Johns Hopkins Medicine Full time

    Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. YOU belong here. What awaits you: Work-life balance - This is a remote role! Medical, Dental, and Vision Insurance. 403B...

  • LabWare LIMS Principal Consultant

    11 hours ago

    East Hanover, New Jersey, United States Sonsoft Inc Full time

    About Sonsoft Inc.Sonsoft Inc. is a USA-based corporation, duly organized under the laws of the Commonwealth of Georgia. We are a growing company specializing in software development, consultancy, and information technology-enabled services.Job OverviewWe are seeking a highly experienced professional to join our team as a LabWare LIMS Principal Consultant....

  • Network Relations Consultant

    1 week ago

    Hanover, United States Johns Hopkins Medicine Full time

    Apply Refer a Friend Back Share This Page Share on Facebook Share on Twitter Share on LinkedIn Share via Email Job Details Requisition #: 643815 Location: Johns Hopkins Health System, Hanover, MD 21076 Category: Non-Clinical Professional Schedule: Day Shift Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are...

  • SAP BTP Consultant

    4 weeks ago

    Hanover Park, United States Sovereign Technologies Full time

    Title: SAP BTP Consultant Location: Lincolnshire, IL Duration: 1 years Skill: They need a resource who has BTP experience within SAP. Sap has a platform called btp (business technology platform). Experience working in a team environment using a software version control system Experience in hands-on development and troubleshooting on embedded targets...

  • Immunology Business Lead

    3 days ago

    East Hanover, New Jersey, United States Novartis Group Companies Full time

    Job SummaryWe are seeking a highly skilled Strategic Immunology Director to join our team at Novartis Group Companies. As a key member of our Immunology Therapeutic Area Leadership group, you will be responsible for delivering strategic business projects that drive growth and innovation in the immunology space.Key Responsibilities:Develop in-depth subject...

  • LabWare LIMS Principal Consultant

    2 days ago

    East Hanover, United States Sonsoft Inc Full time

    Sonsoft, Inc. is a USA based corporation duly organized under the laws of the Commonwealth of Georgia. Sonsoft Inc. is growing at a steady pace specializing in the fields of Software Development, Software Consultancy, and Information Technology Enabled Services.Job DescriptionAt least 9 years of experience in Business Process Consulting, problem definition,...

  • LabWare LIMS Principal Consultant

    2 days ago

    East Hanover, United States Sonsoft Inc Full time

    Sonsoft, Inc. is a USA based corporation duly organized under the laws of the Commonwealth of Georgia. Sonsoft Inc. is growing at a steady pace specializing in the fields of Software Development, Software Consultancy, and Information Technology Enabled Services.Job DescriptionAt least 9 years of experience in Business Process Consulting, problem definition,...

  • LabWare LIMS Principal Consultant

    4 weeks ago

    East Hanover, United States Sonsoft Inc Full time

    Sonsoft, Inc. is a USA based corporation duly organized under the laws of the Commonwealth of Georgia. Sonsoft Inc. is growing at a steady pace specializing in the fields of Software Development, Software Consultancy, and Information Technology Enabled Services. Job Description At least 9 years of experience in Business Process Consulting, problem...

  • Customer Support Consultant

    1 month ago

    Hanover, United States Themis Insight Full time

    Themis Insight solves difficult business, IT, and analytic problems by addressing the whole problem – not just the symptoms – using interdisciplinary approaches that are both practical and innovative. We provide fresh alternatives to ordinary, mainstream consulting firms through small, highly skilled, and hand-picked teams that can meet clients'...

  • Healthcare Economics Specialist

    3 months ago

    Hanover, United States Johns Hopkins Medicine Full time

    Johns Hopkins Health Plans is a leader in provider-sponsored health plans. If you are interested in improving how healthcare is delivered, and have a passion to be at the forefront of change, JHHP is the place to call home. YOU belong here. What awaits you: Work-life balance - This is a remote role! Medical, Dental, and Vision Insurance. 403B...