Actuarial Analyst I/II/III/IV

Excellus BCBS•Rochester, NY

About The Position

Summary: The Actuarial Analyst performs actuarial services in support of Health Plan operations and monitors and maintains financial solvency through the understanding of current data & environment and modeling of future events. This role is amongst the group that is responsible for providing a range of experience working to establishing rates, rating structures and systems and reserves. The Actuarial Analyst has accountability to providing in depth analysis on the overall risk management and financial solvency for the health plan operation. Essential Accountabilities: Level I Establishes insurance rates, rating structures, and rating systems for groups and categories of business. Maintains reserve programs, pricing files, risk score models, benefit relativity tables and appropriate documentation for work. Develops financial projections, risk score analysis, unpaid claim liability estimates and conducts actuarial analysis for well-defined projects as directed. Compiles and analyzes data to draw conclusions and make recommendations. Proposes and assists in the development of process improvements utilizing system and software applications to full potential and participates in activities and projects as directed. Continued professional growth in Actuarial field as evidenced by participation in the Actuarial Study Program, attainment of credentials, and maintaining applicable annual continuing education requirements. Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct, and leading with the Lifetime Way values and beliefs. Consistently adheres to the Actuarial Standards of Practice and the Code of Professional Conduct as promulgated by the Actuarial Standards Board Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures. Regular and reliable attendance is expected and required. Performs other functions as assigned by management. Level II (in addition to Level I Accountabilities) Conducts analyses for and communicates with other departments on various initiatives. Assists the development of actuarial analyses concerning complex issues & trends, coordinates with staff. Reconciles Data Warehouse data with corporate financials or encounter submissions and identifies and develops corrective action with regards to Data Warehouse integrity issues. Initiates and leads efforts to continually improve data capabilities and quality of department analysis and reporting. Proactively and independently ideates process improvements, researches, and recommends changes to actuarial processes. Draws together facts and input from a variety of sources. Level III (in addition to Level II Accountabilities) Reviews and ensures pricings are consistent with established profitability targets for business segments priced in Actuarial. Develops actuarial analyses concerning complex issues and trends, coordinating with several different disciplines and staff. Provides effective technical advice and support to assist management in meeting corporate goals and identifying strategy. Involves other departmental areas. Leads departmental projects and initiatives with other actuarial staff. Prepares actuarial statements of opinion. Level IV (in addition to Level III Accountabilities) Represents the Actuarial Department on special projects involving other areas of the company or external constituents. Performs data exploration using a combination of statistical programming languages and deploys advanced statistical techniques to improve risk prediction, improve reserve, trend and financial forecasting in a manner that is actuarially sound, and enable real-time results and operational efficiencies. Leads organizational projects with internal and external partners. Interprets how regulatory changes affect Health Plan and develops impact analyses, processes and guidelines. Collaborates with senior leadership in meeting corporate goals and strategic planning and decision making. Recommends departmental annual performance goals. Minimum Qualifications: NOTE: We include multiple levels of classification differentiated by demonstrated knowledge, skills, and the ability to manage increasingly independent and/or complex assignments, broader responsibility, additional decision making, and in some cases, becoming a resource to others. In addition to using this differentiated approach to place new hires, it also provides guideposts for employee development and promotional opportunities. All Levels Bachelor’s Degree in a related field with at least one (1) Society of Actuary (SOA) exam passed required. Prior actuarial or related insurance industry experience preferred. Strong analytical skills, verbal and written communication skills. Strong interpersonal skills with demonstrated ability and willingness to collaborate with other team members. Ability to prioritize, multitask, and maintain multiple simultaneous projects. Intermediate technical skills including proficiency in Microsoft Office Suite Strong programming skills in SQL, SAS, VBA, or similar programming language is preferred. Level II (in addition to Level I Qualifications) Two (2) years of actuarial or related experience with at least three (3) passed SOA exams. An understanding of health insurance & health insurance products, managed care, accounting principles, the competitive market, the legislative environment, and any regulatory issue affecting the Health Plan. Self-starter with the ability to work independently. Intermediate proficient programming skills in SQL, SAS, VBA, or similar programming language. Ability to assess and implement efficiency enhancing processes. High level understanding of non-Actuarial functions such as Rating & Underwriting, Finance, Provider Contracting, Analytics & Data Technology, Population Health Engagement, Marketing & Sales, etc., and how they impact Health Plan operations and financials. Level III (in addition to Level II Qualifications) Four (4) years of actuarial or related experience with at least four (4) passed SOA exams. Ability to perform complex modeling independently. Understanding of financial and economic trends, financial regulations and complex financial modules. Strong ability to recognize and automate repetitive tasks. Ability to communicate analytical findings at the appropriate level of detail for receiving audience. Ability to write and communicate statements of actuarial opinion. Level IV (in addition to Level III Qualifications) Six (6) years of actuarial or related experience with at least six (6) passed SOA exams. Advanced understanding of non-Actuarial functions such as Rating, Underwriting, Accounting, Provider Contracting, Network Management, Product Development, Medical Management, etc., and how they impact Health Plan operations and financials. Advanced ability to independently communicate analytical findings at the appropriate level of detail for receiving audience. Ability to independently write, communicate, and present statements of actuarial opinion to both actuarial and non-actuarial audiences.

Requirements

Bachelor’s Degree in a related field with at least one (1) Society of Actuary (SOA) exam passed required.
Strong analytical skills, verbal and written communication skills.
Strong interpersonal skills with demonstrated ability and willingness to collaborate with other team members.
Ability to prioritize, multitask, and maintain multiple simultaneous projects.
Intermediate technical skills including proficiency in Microsoft Office Suite
Strong programming skills in SQL, SAS, VBA, or similar programming language is preferred.
Two (2) years of actuarial or related experience with at least three (3) passed SOA exams.
An understanding of health insurance & health insurance products, managed care, accounting principles, the competitive market, the legislative environment, and any regulatory issue affecting the Health Plan.
Self-starter with the ability to work independently.
Intermediate proficient programming skills in SQL, SAS, VBA, or similar programming language.
Ability to assess and implement efficiency enhancing processes.
High level understanding of non-Actuarial functions such as Rating & Underwriting, Finance, Provider Contracting, Analytics & Data Technology, Population Health Engagement, Marketing & Sales, etc., and how they impact Health Plan operations and financials.
Four (4) years of actuarial or related experience with at least four (4) passed SOA exams.
Ability to perform complex modeling independently.
Understanding of financial and economic trends, financial regulations and complex financial modules.
Strong ability to recognize and automate repetitive tasks.
Ability to communicate analytical findings at the appropriate level of detail for receiving audience.
Ability to write and communicate statements of actuarial opinion.
Six (6) years of actuarial or related experience with at least six (6) passed SOA exams.
Advanced understanding of non-Actuarial functions such as Rating, Underwriting, Accounting, Provider Contracting, Network Management, Product Development, Medical Management, etc., and how they impact Health Plan operations and financials.
Advanced ability to independently communicate analytical findings at the appropriate level of detail for receiving audience.
Ability to independently write, communicate, and present statements of actuarial opinion to both actuarial and non-actuarial audiences.

Nice To Haves

Prior actuarial or related insurance industry experience preferred.
Strong programming skills in SQL, SAS, VBA, or similar programming language is preferred.

Responsibilities

Establishes insurance rates, rating structures, and rating systems for groups and categories of business.
Maintains reserve programs, pricing files, risk score models, benefit relativity tables and appropriate documentation for work.
Develops financial projections, risk score analysis, unpaid claim liability estimates and conducts actuarial analysis for well-defined projects as directed.
Compiles and analyzes data to draw conclusions and make recommendations.
Proposes and assists in the development of process improvements utilizing system and software applications to full potential and participates in activities and projects as directed.
Continued professional growth in Actuarial field as evidenced by participation in the Actuarial Study Program, attainment of credentials, and maintaining applicable annual continuing education requirements.
Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct, and leading with the Lifetime Way values and beliefs.
Consistently adheres to the Actuarial Standards of Practice and the Code of Professional Conduct as promulgated by the Actuarial Standards Board Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
Regular and reliable attendance is expected and required.
Performs other functions as assigned by management.
Conducts analyses for and communicates with other departments on various initiatives.
Assists the development of actuarial analyses concerning complex issues & trends, coordinates with staff.
Reconciles Data Warehouse data with corporate financials or encounter submissions and identifies and develops corrective action with regards to Data Warehouse integrity issues.
Initiates and leads efforts to continually improve data capabilities and quality of department analysis and reporting.
Proactively and independently ideates process improvements, researches, and recommends changes to actuarial processes.
Draws together facts and input from a variety of sources.
Reviews and ensures pricings are consistent with established profitability targets for business segments priced in Actuarial.
Provides effective technical advice and support to assist management in meeting corporate goals and identifying strategy.
Involves other departmental areas.
Leads departmental projects and initiatives with other actuarial staff.
Prepares actuarial statements of opinion.
Represents the Actuarial Department on special projects involving other areas of the company or external constituents.
Performs data exploration using a combination of statistical programming languages and deploys advanced statistical techniques to improve risk prediction, improve reserve, trend and financial forecasting in a manner that is actuarially sound, and enable real-time results and operational efficiencies.
Leads organizational projects with internal and external partners.
Interprets how regulatory changes affect Health Plan and develops impact analyses, processes and guidelines.
Collaborates with senior leadership in meeting corporate goals and strategic planning and decision making.
Recommends departmental annual performance goals.