Senior Actuarial Analyst - Heath Plan

SCAN Health Plan • Long Beach, CA

1d • Remote

About The Position

The Senior Actuarial Analyst contributes to the success of the Actuarial team by preparing and analyzing data for network contract modeling, identifying opportunities to improve model efficiency, and supporting effective communication with the network team. Senior Actuarial Analysts typically have several years of experience in the field and may also be involved in mentoring and training junior analysts.

Requirements

• Bachelor's Degree in Actuarial Science, Mathematics, or Statistics or any other major with significant quantitative course work is required.
• 3+ years of healthcare actuarial, healthcare economic, or healthcare finance experience; or comparable consulting experiences.
• Experience with provider contract modeling and Medicare FFS structure.
• Certifications deemed to be reasonable to function at this level.
• 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.
• May provide leadership, coaching, and/or mentoring to a subordinate group.
• Advanced Analytical Skills: Proficient in using statistical and mathematical models to analyze complex data sets, identify trends, and make informed predictions.
• Technical Proficiency: Expertise in actuarial software and tools such as Excel, SQL, and specialized actuarial modeling software.
• Communication and Collaboration: Strong ability to communicate technical information clearly to non-technical stakeholders and work effectively in cross-functional teams.
• Microsoft Office Suite (Word, Excel including formulas, V-Lookups, and pivot tables, PowerPoint, Access, Outlook, Teams), and SQL at advance level is required.

Nice To Haves

• Curious about AI and its power to transform how we operate and serve our members.

Responsibilities

• Use tools that currently exist to support provider contract negotiations for globally capitated and shared risk providers.
• Support to include financial modeling, DOFR valuations (internal claims extraction / analysis and external research), health care cost trend, risk analysis, and advice / guidance to the Network Management and Contracting teams.
• Develop ad hoc provider claims modeling and analysis for fee-for-service provider negotiations.
• Financial analyses may incorporate Medicare fee schedules and potentially repricing.
• Support ad-hoc analytics such as product development, and other customized projects to suit business needs.
• Utilize the Data Warehouse efficiently to develop reports and extract data fields.
• Assist the actuarial team with the development of Medicare Advantage bid by keeping track of network assumptions and scenarios.
• 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

• Base salary range: $90,000 to $120,000 per year
• Internal title: Actuarial Analyst Sr
• Work Mode: Mostly Remote
• 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
• An opportunity to become part of a team that makes a difference to our members and our community every day!

What This Job Offers

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