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Actuarial Analyst

Posted on Oct 23, 2019 by Connecticare

Farmington, CT 06030
Accountancy
Immediate Start
Annual Salary
Full-Time
Summary : This position will perform actuarial analyses for Commercial and Medicare business including, but not limited to: medical expense analyses and projections, determining rates and preparing supporting documentation for rate filings with DOI and HHS/CMS, pharmacy analytics and projections, building and maintaining rate models, analyzing data in support of monthly reserve process, and ad hoc actuarial analyses. Responsibilities: Provide data and support for the development of rate filings for submission to the Department of Insurance. Includes support documentation. Provide data and support for the development of Medicare Advantage bids for submission to CMS. Includes support documentation. Closely monitors and assesses competitors? rates, trends and rating methodologies. Support the valuation of monthly reserve estimates for proper financial accounting. Supports various initiatives as needed by actuarial modeling. Provide support to audits, statutory exams, and regulatory inquiries as needed. Develops/enhances ad hoc reports to assist in actuarial analyses of emerging results. Creates and maintains large databases of information utilizing a unique skill set of spreadsheet and relational database abilities. Conducts cross-functional analysis of health care data to identify trends and risks. Develop data and reports in support of all Federal and State regulations, including risk adjustment, state and federal high risk pools, and MLR rebate determination. Drill into medical expense problem areas, and provide results to Medical Management and Network Operations in order to determine, implement, and monitor solutions. Develops/enhances ad hoc reports to assist in financial analysis of operating results and support for actuarial analyses key to understanding financial position. Assess the financial or pricing impact of variations in benefits, provider contracts, trends, and utilization changes. Estimate mandated benefit cost and calculate pricing of non-standard benefits and requested riders. Perform other related projects and duties as assigned. Qualifications: Bachelor's Degree required, preferably in Actuarial Science/Mathematics/Finance/Healthcare Management or a related field or an equivalent combination of education and experience. At least 2 years of previous experience in actuarial analysis desired. Excellent quantitative, problem solving and analytical skills. Strong communication skills. Technical skills with database concepts, data analysis development, data warehousing and decision support tools. Knowledge of MS-Office products, particularly MS-Access and Excel are required. Familiarity with SQL and SAS desired. Essential Job Functions: Primarily sedentary Must be able to use standard office equipment

Reference: 779025343

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