Senior Actuarial Analyst (Pharmacy)

REMOTE

Summary:

• Identify opportunities to reduce medical expenses and collaborate with other areas to implement and monitor performance.

• Participate in product development, pricing, filing, and rating implementation of new products and strategies.

• Develop studies, analyses, and presentation materials needed to appropriately inform decision makers.

• Answer questions of less experienced staff.

Responsibilities:

• Analyze and understand hospital, professional, and drug claim/utilization trends, membership/demographics, and financial variance to budget, and performs various other ad-hoc analyses.

• Maintain appropriate controls around models and other work products.

• Ensure quality and on time completion of deliverables.

• Provide support for coordination of quarterly close activities.

• Partner with key stakeholders to develop and finalize valuation methodologies.

• Prepare and analyze results and forecasts.

• Perform monitoring processes for trends and risk valuation calculations.

• Develop efficient and transparent queries to obtain data that is appropriate to the purpose with minimal assistance and oversight.

• Make appropriate recommendations to management across teams within the actuarial department.

• Proactively ensure the internal and external consistency of all work.

• Perform reasonability checks dependent on industry knowledge and experience.

• Develop and implement analyses for special projects.

• Provide technical and analytical support for both the Actuarial department and internal partners.

• Proactively take on additional work as needed by the team.

• Perform duties and assignments as directed or required.

Qualifications:

Education, Training, Licenses, Certifications

• Bachelor's degree in Actuarial Science, Mathematics, other physical science, or related finance/business degree required

• Associate of the Society of Actuaries required

Relevant Work Experience, Knowledge, Skills, and Abilities

• 4 - 6+ years of relevant, professional work experience and/or education required

• 1 - 2+ years health insurance actuarial experience, preferably in the managed care industry required

• Must make sufficient progress toward obtaining actuarial credentials, defined as sitting for a minimum of one exam per year, scoring above a zero, and obtaining at least a combined score of 5 over two consecutive sittings

• When unable to meet the progress outlined in the bullet above, the role will be transitioned to a non-Actuarial job title and job description

• Comprehensive understanding of actuarial principles and methodologies and strong mathematical and analytical skills required

• Excellent communication skills (verbal, written, presentation) required

• Strong working knowledge of MS Office including Outlook, Word, Excel, PowerPoint, etc. required

• Working knowledge of SQL, R, Python or similar required

• Capable with Excel, data extraction, simulations, automation required

• Knowledge of reimbursement methodologies required

• Capable with Excel, data extraction, simulations, automation.

• Knowledge of reimbursement methodologies.

Additional Information

• Requisition ID: ...
• Hiring Range: $68,040-$118,800