Actuarial Analyst - Health Plan
About The Position
The Actuarial Analyst contributes to the success of the Actuarial team by preparing and analyzing data for Part D bids, maintaining models, performing financial projections and monthly pharmacy cost reports, and supporting contract modeling. The role involves preparing and analyzing data for Part D, developing comparisons between actual versus forecast, and supporting ad-hoc analytics such as provider contracting and product development. The analyst will utilize the Data Warehouse to develop reports and extract data, analyze historical data trends to establish reasonable assumptions, and assist with Medicare Advantage bid pricings by tracking input parameters and testing benefit scenarios. Additionally, the role supports the financial budget and forecasts of pharmacy costs, monitors actual results, and proactively identifies opportunities to streamline workflows, enhance model efficiency, and improve automation. The position requires intellectual curiosity and a continuous improvement mindset, with a focus on AI's transformative power. The analyst will actively support SCAN's Vision and Goals and perform other duties as assigned.
Requirements
- Bachelor’s degree in Actuarial Science, Mathematics, or Statistics or any other major with significant quantitative course work required.
- 2-4 years of actuarial experience with healthcare, health plan, or managed care focus, or comparable actuarial consulting experiences.
- Experience with Medicare, Medicaid, Part D, commercial health insurance, or network contracting for a health plan is highly preferred.
- Performs work under general supervision.
- Handles moderately complex issues and problems, and refers more complex issues to higher-level staff.
- Possesses solid working knowledge of subject matter.
- Strong analytical skills.
- Microsoft Office Suite (Word, Excel including formulas, V-Lookups, and pivot tables, PowerPoint, Access, Outlook, Teams), and SQL at advance level is required.
- Basic problem solving skills and strong mathematics skills.
- Good written and verbal communication and interpersonal skills.
Nice To Haves
- Experience with Medicare, Medicaid, Part D, commercial health insurance, or network contracting for a health plan is highly preferred.
Responsibilities
- Prepare and analyze data for Part D bids and develop comparisons between actual versus forecast.
- Support ad-hoc analytics such as provider contracting, product development, and other customized projects to suit business needs.
- Utilize the Data Warehouse efficiently to develop reports and extract data fields.
- Analyze historical data trends in order to establish reasonable assumptions.
- Assist the actuarial team with the development of Medicare Advantage bid pricings by keeping track of various input parameters and testing benefit scenarios.
- Assist the financial budget and forecasts of pharmacy costs and the ongoing monitoring of actual results.
- Proactively identify opportunities to streamline workflows, enhance model efficiency, and improve automation of existing processes.
- Bring intellectual curiosity and a continuous improvement mindset to all assigned work, challenging the status quo where appropriate.
- Actively support the achievement of SCAN’s Vision and Goals.
- Other duties as assigned.
Benefits
- An annual employee bonus program
- Robust Wellness Program
- Generous paid-time-off (PTO)
- Eleven paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday
- Excellent 401(k) Retirement Saving Plan with employer match and contribution
- Robust employee recognition program
- Tuition reimbursement
- A competitive compensation and benefits program
- An opportunity to become part of a team that makes a difference to our members and our community every day!
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
