Actuary- Insurance Services Value Based Contracting (Remote, US)
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UPMC Health Plan has an exciting opportunity for an Actuary on their rockstar Value-Based Contracting Team!
This position applies knowledge of mathematics, probability and statistics in order to identify issues, 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.
Preferences:
? Working experience in SQL and Excel
? Experience with at least 2 actuarial rotations in the following fields: value-based contracting, pricing, reserving, trend/health economics, provider network analysis, risk adjustment, etc
? FSA or ASA
This role can be remote anywhere within the US!
Responsibilities: ? Responsible for the development of mathematical models in connection with other departments to predict the impact of proposed changes. ? Reports to head of actuarial department or Actuarial Manager. ? Presents results of analyses and recommendations to management. ? Documents methods, procedures and results. ? Preparation of State and Federal filings. Including Federal Exchange, Pennsylvania Insurance Department Filings and Medicare Bid Submissions. ? Will own project management of projects, including deliverables and appropriate work. ? Will direct and supervise junior actuarial department personnel in the performance of duties. ? 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.- Review of other's work product.
Qualifications: ? Bachelor's degree in mathematics, statistics, actuarial science, economics or related field ? And 5+ years of experience in actuarial work in health insurance, managed care or related consulting business; or equivalent training, education and/or experience. ? Excellent problem-solving and analytical skills. ? ASA certification
Licensure, Certifications, and Clearances:
A.S.A. or F.S.A. certification by Society of Actuaries Membership in the American Academy of Actuaries
? Act 34
? UPMC is an Equal Opportunity Employer/Disability/Veteran
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