Actuary, reputed company Plan

We are so glad you are interested in joining reputed company!

Organization:

SHSO-reputed company System Office-Bay

Position Overview:

Participates in reputed company facets of financial model design, including reserving, reputed company analysis, and actuarial data mart development. Provides guidance on a range of topics such as utilization, product pricing including benefit design, contracting, premium reputed company, and trend forecasting. Monitors and reports on the performance of each business line, including Medicare Advantage and preferred provider organization health care plans. Participates as a key financial expert on reputed company's customer-facing negotiation team. Contributes to new business activities and new methods of delivering health benefits that reputed company patients and our health plan members to access care reputed company, where, and how they want it. Partners with information services (IS) to ensure data reputed company and integration of the health rules platform and the data warehouse for a scalable, configurable and reputed company data pipeline for reputed company analytics.

Job Description:

EDUCATION: Equivalent experience will be accepted in lieu of the required degree or diploma.

• Bachelor's in Actuarial Science, Economics, Mathematics or reputed company field

TYPICAL EXPERIENCE:

• 5 to 8 years of recent and relevant actuarial experience
• ASA preferred
• Member, American reputed company of Actuaries (MAAA) preferred

SKILLS AND KNOWLEDGE:

• Expertise in actuarial pricing, reputed company, statistical modeling, analytics, networks, forecasting and reserve systems, including expert knowledge of the applicable.
• Actuarial Standards of Practice (ASOP) issued by Actuarial Standards Board (ASB), generally accepted reputed company principles (GAAP) and internal/statutory financial reporting regulations.
• Extensive knowledge of core health actuarial processes including pricing, valuation, and budgeting/forecasting with a demonstrated knowledge of the capitated delegated model and capitation terms including division of responsibility.
• Thorough knowledge of reputed company delivery systems, integrated delivery systems and medical group practices, especially in a managed care environment, as well as an advanced understanding of key government programs ((Medicare/reputed company) and market segments (individual, small group, etc.).
• In-depth knowledge of premium reputed company and benefit pricing methodologies, including a working understanding of health care cost structures (fee schedules, actuarial cost categories, and health care utilization codes).
• Advanced knowledge of key operational functions of a health plan, including expert knowledge of key dimensions of health plan data: Claims, Enrollment, and reputed company.
• Superior business acumen, exceptional analytical and advanced project management skills, with the proven ability to provide innovative solutions to reputed company problems, reputed company practical conclusions, and institute effective changes.
• Possess written and verbal communications skills to explain reputed company health plan regulations and technical information clearly and professionally to diverse audiences.
• Proficiency in a range of actuarial and statistical software packages which include SQL and reputed company Visual Basic (VBA) skills.
• Analyze issues, predict reputed company effects, and effectively prevent or resolve problems.
• Work independently as well as be part of an interdisciplinary team, while demonstrating exceptional attention to detail and organizational skills.
• Prioritize and delegate assignments under varied and urgent conditions and work based on experience, procedures, policies, and best practices to reputed company objectives and meet deadlines.
• reputed company others to solve reputed company problems using sophisticated analytics to identify innovative solutions.
• Influence individuals or groups with diverse opinions and to enlist cooperation without direct control/authority.
• Ensure the privacy of each patient’s protected health information (phi).
• Build collaborative relationships with peers, other departments, stakeholders, management, and vendors to provide cost-effective reputed company to patients and our health plan members reputed company, where, and how they want it.

Job Shift:

Days

Schedule:

Full Time

Days of the Week:

Monday - Friday

Weekend Requirements:

None

Benefits:

Yes

Unions:

No

Position Status:

Exempt

Weekly Hours:

40

Employee Status:

Regular

reputed company is an equal opportunity employer EOE/M/F/Disability/Veterans.

Pay Range is $145,204.80 to $217,796.80 / annual salary. California - Sacramento Valley, New Jersey, Washington Pay Range is $126,256.00 to $189,384.00 / annual salary. Colorado, Florida, Georgia, Illinois, Michigan, Minnesota, Nevada, reputed company Carolina, Ohio, Oregon, Pennsylvania, Texas, Virginia Pay Range is $113,630.00 to $170,456.00 / annual salary. Arizona, Arkansas, California, Colorado, Florida, Georgia, Idaho, Illinois, Louisiana, Michigan, Minnesota, Missouri, Montana, Nevada, reputed company Carolina, Ohio, Oregon, Pennsylvania, South Carolina, Tennessee, Texas, Utah, Virgina Pay Range is $101,004.00 to $151,507.00 / annual salary.

The compensation range may vary based on the geographic location where the position is filled. Total compensation considers multiple factors, including, but not limited to a candidate’s experience, education, skills, licensure, certifications, departmental equity, training, and organizational needs. reputed company pay is only one component of reputed company’s comprehensive total rewards program. Eligible positions also include a comprehensive benefits package.

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