About The Position
Provides guidance and vision for complex data analytics to provide leadership with strategic business intelligence around financial and operational performance. Compiles claims, enrollment, revenue, and other statistical data to use in assigned projects. Conducts data analysis, performs financial modeling and designs reporting to support the Health Plan requirements and initiatives. Communicates summarized results to stakeholders via written narratives, graphical representations, and presentations. Mentors staff on Industry and Health Plan knowledge.
Requirements
- Bachelor's Degree-Related Field of Study (Required)
- Minimum of 5 years-Relevant experience (Preferred)
- Actuarial Function
- Communication
- Computer Literacy
- Insurance Finance And Actuarial Concepts
- Organizing
- Problem Management
- Statistics And Actuarial Modeling
Nice To Haves
- Relevant experience may be a combination of related work experience and/or Master's degree obtained or Actuarial Exams completed (Master's Degree = 2 years relevant experience, 1 Actuarial Exam = 1 year relevant experience, 3 Actuarial Exams = 2 years relevant experience).
Responsibilities
- Produces and provides analytical and technical support for assigned projects using data analysis tools and software.
- Performs complex analyses by utilizing a wide-range of quantitative and qualitative data sets, models, and publications (regulations, guidelines, business rules, reporting requirements and standards).
- Analyzes data output to identify and interpret trends or patterns in complex data sets.
- Applies advanced business, statistical, and actuarial concepts (Credibility, Simulation, Frequency, Severity) to help support and enhance decision making.
- Synthesizes information to create and deliver clear, precise, and actionable information to stakeholders.
- Delivers information in writing or through verbal summaries and dashboards and reports and presentations.
- Validates and exchanges data provided to and received from other departments, strategic business partners, or other external parties.
- Develops and maintains technical business rules and documentation for data mart metrics and tables.
- Serves as subject matter expert or data steward in data governance and data quality initiatives to ensure and maintain integrity of the Health Plan data stores.
- Serves as a liaison to all levels of Health Plan staff including leadership, other departments, Medical Directors, external vendors, and business partners as requested to analyze data sets and information.
- Provides technical, analytical and business guidance within actuarial team and across the Health Plan departments as necessary.
- Mentors analysts and/or interns providing guidance as needed.
- Monitors and translates key reimbursement, healthcare reform, and regulation policy issues that may impact the Health Plan.
- Develops detailed recommendations and operational strategies to implement these changes and presents to senior management.
- Accountable for satisfying all job specific obligations and complying with all organization policies and procedures.
Benefits
- healthcare benefits for full time and part time positions from day one
- vision
- dental
- benefits for domestic partners
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Number of Employees
5,001-10,000 employees
