Sr. Actuarial Analyst

4 months ago

New York, United States EmblemHealth Full time
Summary:
  • Identify opportunities to reduce medical expenses and collaborate with other areas to implement and monitor performance.
  • Participate in product development, pricing, filing, and rating implementation of new products and strategies.
  • Develop studies, analyses, and presentation materials needed to appropriately inform decision makers.
  • Answer questions of less experienced staff.

Responsibilities:
  • Analyze and understand hospital, professional, and drug claim/utilization trends, membership/demographics, and financial variance to budget, and performs various other ad-hoc analyses.
  • Maintain appropriate controls around models and other work products.
  • Ensure quality and on time completion of deliverables.
  • Provide support for coordination of quarterly close activities.
  • Partner with key stakeholders to develop and finalize valuation methodologies.
  • Prepare and analyze results and forecasts.
  • Perform monitoring processes for trends and risk valuation calculations.
  • Develop efficient and transparent queries to obtain data that is appropriate to the purpose with minimal assistance and oversight.
  • Make appropriate recommendations to management across teams within the actuarial department.
  • Proactively ensure the internal and external consistency of all work.
  • Perform reasonability checks dependent on industry knowledge and experience.
  • Develop and implement analyses for special projects.
  • Provide technical and analytical support for both the Actuarial department and internal partners.
  • Proactively take on additional work as needed by the team.
  • Perform duties and assignments as directed or required.


Requirements:
  • Bachelor's degree in Actuarial Science, Mathematics, other physical science, or related finance/business degree required
  • 2 or more Actuarial exams completed and passed required
  • 4 - 6+ years of relevant, professional work experience and/or education required
  • 1 - 2+ years health insurance actuarial experience, preferably in the managed care industry required
  • Must make sufficient progress toward obtaining actuarial credentials, defined as sitting for a minimum of one exam per year, scoring above a zero, and obtaining at least a combined score of 5 over two consecutive sittings.
  • When unable to meet the progress outlined in the bullet above, the role will be transitioned to a non-Actuarial job title and job description.
  • Comprehensive understanding of actuarial principles and methodologies and strong mathematical and analytical skills required
  • Excellent communication skills (verbal, written, presentation) required
  • Strong working knowledge of MS Office including Outlook, Word, Excel, PowerPoint, etc. required
  • Working knowledge of SQL, R, Python or similar required
  • Capable with Excel, data extraction, simulations, automation required
  • Knowledge of reimbursement methodologies required

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