Lead Analyst, Pricing

HMSA • Honolulu, HI

20h

About The Position

For assigned line(s) of business, the Lead Actuarial Analyst will:

1. Lead the pricing and rating of HMSA's products, including the following:

Collecting and analyzing historical experience data, developing
projections and modeling financial outcomes under various rating
scenarios.
Regularly updating the rating methodology and factors for HMSA's ACA
Individual and Small Group lines of business, including pricing model
updates, Risk Adjustment payment analysis and associated rate filings
documents preparation.
Supporting the development of annual Medicare bid submissions and group
retiree pricing, including pricing soundness check on gain/loss), risk
score and payment, advising on process improvement etc.
Support QUEST program including capitation rate impact analysis,
regulatory compliance and data integrity & encounter analysis.
Configuring and testing rate tables and factors in HMSA's systems.
2. Lead complex trend analysis and projections, including:

Monitoring emerging experience monthly, reconciling this against other
sources and comparing against budget/forecast.
Analyzing significant utilization, unit cost and other trend drivers, as
well as variances against budget/forecast.
Based on emerging trends, known/projected provider contract and other key
drivers, lead the development of trend forecasts to be used for financial
projection and rating purposes.
3. Produce ad-hoc financial & statistical analyses, data pulls or studies, as
needed.
4. Assist the annual budget and reforecast of various LOBs. Other financial
reporting duties, as assigned.
5. Lead the creation of revenue and expense projections at the line of business
level. Monitor emerging experience against these projections and produce
variance analyses on a regular basis.
6. Performs all other miscellaneous responsibilities and duties as assigned or
directed.

Requirements

• Bachelor's degree and passed three actuarial exams with four years of relevant work experience
• Working knowledge of actuarial and underwriting concepts.
• Effective written and verbal communication skills.
• Strong mathematical, analytical and problem-solving skills
• Proficient working knowledge of Microsoft Office Word, Outlook, and PowerPoint.
• Advanced knowledge of Microsoft Excel.

Responsibilities

• Lead the pricing and rating of HMSA's products
• Lead complex trend analysis and projections
• Produce ad-hoc financial & statistical analyses, data pulls or studies, as needed.
• Assist the annual budget and reforecast of various LOBs. Other financial reporting duties, as assigned.
• Lead the creation of revenue and expense projections at the line of business level.
• Performs all other miscellaneous responsibilities and duties as assigned or directed.

What This Job Offers

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