Actuarial Services Manager - Jefferson Health Plan

Jefferson Health Plans • Philadelphia, PA

1d • Onsite

About The Position

The Actuarial Services Manager supports the Director of Actuarial Services across the Actuarial Department’s needs. The role improves analytics and business decision support, as well as information and processes for the Medicaid and CHIP lines of business, reserving, budgeting, forecasting, and regulatory filings. The manager conducts routine and ad hoc actuarial or financial analyses individually and with other staff, under the Director’s guidance.

Requirements

• Bachelor’s degree in actuarial science, mathematics, statistics, or another analytical field.
• At least 3 years of actuarial experience in Medicaid, health care data reporting, and analysis.
• Associate of the Society of Actuaries (ASA) credential required.
• Ability to independently perform reasonability checks on completed work and recognize when further analysis is needed to understand and explain results.
• Strong problem-solving, quantitative, and analytical skills.
• Advanced ability to use spreadsheet software, including Excel and VBA, and database software, including Access, to design and build reports and models.
• Self-motivated and able to manage multiple priorities.

Nice To Haves

• Familiarity with SQL.

Responsibilities

• Estimate monthly IBNR and maintain and improve models and processes.
• Communicate results to management and identify problem areas.
• Work with Utilization Management to identify and monitor potential large cases and estimate JHP’s potential liability.
• Support financial reporting.
• Support financial budgeting and forecasting.
• Develop and analyze unit cost and utilization trends.
• Perform actual-versus-expected analytics and variance analysis.
• Estimate and analyze risk pools and risk sharing.
• Maintain and enhance internal data systems using SQL.
• Prepare and validate routine and ad hoc analyses to support business decisions.
• Design and build models for analyses.
• Use data-mining techniques.
• Serve as an internal Medicaid actuarial point of contact among external auditors and consultants and internal actuarial management.
• Support state and federal regulatory reporting and filing requirements, including the annual CHIP rate filing.
• Support ACA and Medicare lines of business as needed.
• Produce and maintain documentation of routine and periodic processes.

Benefits

• Medical and prescription insurance
• Supplemental insurance
• Dental insurance
• Vision insurance
• Life and AD&D insurance
• Short- and long-term disability insurance
• Flexible spending accounts
• Retirement plans
• Tuition assistance
• Voluntary benefits, including access to group insurance rates and discounts
• Tuition discounts at Thomas Jefferson University after one year of full-time service or two years of part-time service

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level