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Actuarial Analyst III- Behavioral Health Pricing

5 months ago

Pittsburgh, Pennsylvania, United States UPMC Senior Communities Full time
We are UPMC, and we are changing health care for the better. With 96,000 employees, 40 hospitals, 800 doctors' offices and outpatient sites, and a more than 4 million-member Insurance Services Division, we all have one mission: to provide Life Changing Medicine, every day. Whoever you are and whatever you'd like to do, UPMC has a place for you.

UPMC Health Plan's Medicaid/Government Product actuarial team is seeking an Actuarial Analyst III to support the team's Behavioral Health work.

This position applies knowledge of mathematics, probability and statistics to identify issues, and gather and analyze data on a wide variety of topics affecting the financial performance of the health plan. May represent the department on corporate projects. Receives assistance from either management or senior positions when necessary. The Medicaid actuarial team supports PA Medicaid products and this role will focus on support for pricing and reporting for Behavioral Health.

This role can be remote within the continental US.

10 Stand-Out Benefits that UPMC Employees Enjoy

Responsibilities:
  • May direct or supervise junior actuarial department personnel in the performance of duties.
  • Responsible for the development of mathematical models in connection with other departments to predict the impact of proposed changes.
  • Preparation of State and Federal filings.
  • Presents results of analyses and recommendations to management.
  • Documents methods, procedures and results.
  • Responsible for the preparation of financial analyses in support of the following functions: Medical cost and utilization trend analysis; Forecasting; Development of claim reserves (IBNR) Completion factors using claim lag analysis models; Provide analytical support for rate development and filings; Provide ad hoc data analysis to all departments within the company.
Qualifications:
  • Bachelor's degree in mathematics, statistics, actuarial science, economics or related field and
    • 3-5 years of experience in actuarial work in a health insurance, managed care or related consulting business.
  • Pursuing S.O.A. certification
  • Experience working in a BH-MCO preferred.
  • Excellent problem solving and analytical skills. Four actuarial examinations passed or appropriate experience.
  • Good oral and written communication skills.
  • Strong PC skills.
  • Data retrieval skills and relational database experience.
  • Works independently.
    Licensure, Certifications, and Clearances:
  • Act 34
UPMC is an Equal Opportunity Employer/Disability/Veteran

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