Senior Actuarial Analyst, Healthcare Analytics-Remote Option
Posted on Jun 14, 2019 by Molina Healthcare
Performs research and analysis of complex healthcare claims data, pharmacy data, and lab data regarding network utilization and cost containment information. Evaluates, writes, and presents healthcare utilization and cost containment reports and makes recommendations based on relevant findings.
Analyze results to identify early signs of trends or other issues related to medical care costs.
Design and perform studies related to medical care costs and trends
Performs financial modeling of provider contracts so that negotiations are well informed, issues can be anticipated and, as a result, contract terms can be reached on good faith with sustainability.
Performs unit cost and contract valuation analysis in support of network contracting negotiations and unit cost management strategies.
Extract and compile information from various systems to support executive decision-making.
Research and develop reports and analysis for senior management, effectively communicate results.
Assist in the preparation of claim experience reports, rate models, and state regulatory reports.
Review reporting prepared by others to assure consistency and appropriateness of methodologies used. Interpret results and recommend solutions to identified issues.
Qualification: Job Qualifications*3 years experience will be consideredRequired Education Bachelor's Degree in Finance, Economics, Computer Science Required Experience Five or more years of progressive responsibilities in Data, Finance or Systems Analysis Expert knowledge on SQL, SSRS and SSIS or similar tools
Preferred Education Bachelor's Degree in Finance, Economics, Math, or Computer Science Preferred ExperiencePreferred experience in Medical Economics and Strong Knowledge of Performance Indicators\\: Proactively identify and investigate complex suspect areas regarding medical cost issues Initiate in-depth analysis of the suspect/problem areas and suggest a corrective action plan Apply investigative skill and analytical methods to look behind the numbers, assess business impacts, and make recommendations through use of healthcare analytics, predictive modeling, etc. Analysis and forecasting of trends in medical costs to provide analytic support for finance, pricing and actuarial functions Multiple data systems and models BI tools (ProClarity, MEd Insight, etc.,) Preferred License, Certification, AssociationQNXT or similar healthcare payer applications To all current Molina employees\\: If you are interested in applying for this position, please apply through the intranet job listing.Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Associated topics: actuarial, actuarial consultant, actuarial director, actuary consultant, assistant actuary, cost, director actuary, life actuary, model, retirement actuary
$100k - $120k Annual