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Actuary Lead- Value Based Contracting (Remote, US)

Remote: 
Full Remote
Contract: 
Experience: 
Senior (5-10 years)
Work from: 

Offer summary

Qualifications:

Bachelor's degree in mathematics or related field, ASA certification required, 5+ years of actuarial experience, Experience in health insurance or managed care.

Key responsabilities:

  • Present analyses and recommendations to management
  • Support the Medicare Bid process and financial analyses
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UPMC XLarge https://www.upmc.com/
10001 Employees
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Job description

UPMC Health Plan has an exciting opportunity for an Actuary Lead on their rockstar Value-Based Contracting Team!

This position applies knowledge of mathematics, probability, and statistics in order to identify issues and gather and analyze data on a wide variety of topics affecting the financial performance of the health plan. Ensure timely and accurate services to clients. Supports strong internal and external relationships.

Preferences:

  • Working experience in SQL and Excel
  • Experience 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:

  • Presents results of analyses and recommendations to actuarial management.
  • Develop junior actuarial department staff
  • Support the Medicare Bid process, including preparing presentations, providing all requested reports and pricing, responding to desk review queries, and working with other departments to file all bids in a timely manner
  • Responsible for the preparation of financial analyses in support of the following functions: Medical cost and utilization trend analysis; Forecasting; - Provide analytical support for rate development and filings; - Provide ad hoc data analysis to all departments within the company.
  • Documents methods, procedures and results.
  • Provide actuarial support and requests for the annual CMS Financial Audits; communicate with auditors when needed
  • Will direct junior actuarial department personnel in the performance of duties.
  • Price, analyze, and assign annual premium increases/decreases to Medicare Employer Groups; includes communication with product development/ sales and the ability to explain pricing decisions to senior management
  • Review of other's work product.
  • Prepares and reviews Medicare Bid Submissions.
  • Responsible for the development of mathematical models in connection with other departments to predict the impact of proposed changes.
  • Will own project management of projects, including deliverables and appropriate work.
  • Bachelor's degree in mathematics, statistics, actuarial science, economics, or related field
  • Five plus 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.
  • In-depth understanding of health insurance market dynamics.
  • ASA certification at minimum

Licensure, Certifications, and Clearances:

ASA certification, min

  • Act 34
  • UPMC is an Equal Opportunity Employer/Disability/Veteran

Annual

Required profile

Experience

Level of experience: Senior (5-10 years)
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Mathematics
  • Microsoft Excel
  • Analytical Skills
  • Communication
  • Problem Solving

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