No Recruitment Agencies Please. We kindly ask that Recruitment Agencies, persons, and entities refrain from recruiting for this opening and presenting unsolicited resumes. Risk Strategies reserves the right to hire any unsolicited applicant at its discretion and without any fee owed to the submitting Recruitment Agency, person or entity.
United Health Actuarial Services (UHAS), a division of Risk Strategies, provides health actuarial, management and underwriting consulting services supporting the full spectrum of individual and group medical and supplemental health coverages and products for a wide variety of private- and public-sector clients.
The employees of UHAS share a passion for serving our clients. We believe in prompt, courteous service and enjoy building relationships with our customers. Strong lines of communication are crucial to successful engagements, and UHAS has sought to employ professionals who are great communicators in addition to possessing strong technical actuarial skills. The culture at UHAS promotes a close-knit, family-like working environment where teamwork and client satisfaction are valued above all else.
Primary Responsibilities and Duties:
The duties of the Health Care Analytics and Pricing Actuary, include but are not limited to:
- Develop and maintain pricing, projection and valuation models and assumptions for health insurance and other related products.
- Organize, analyze, review and apply cost and utilization data in evaluations of medical cost trends, provider networks, provider contracts, reference-based prices, and value-based contracts.
- Coordinate, prepare and perform complex actuarial analyses and financial modeling (e.g., project reimbursements for a hospital contract relative to Medicare payments or calculate the expected value and variance for an episode-of-care ) relating to financial agreements between payers and providers
- Support the development of actuarial assumptions for health insurance pricing, projecting and benchmarking healthcare costs, and for evaluating risk in a value-based contract
- Perform financial analysis of value-based contracting agreements between payers, providers, and/or health benefits plan sponsors
- Assist clients in designing and developing innovative new approaches to meet desired competitive levels and maintain actuarial soundness
- Prepare actuarial filing materials for rate filings and assist with responding to objections from state insurance departments
- Assist client/project leaders with additional actuarial analyses and/or modeling as requested
Requirements
- Bachelor’s degree in Actuarial Science, Mathematics, Statistics or a related field
- 8+ years of relevant and progressively responsible actuarial experience with health insurance products and provider-payer payment arrangements
- An Associate or Fellow of the Society of Actuaries and a Member of the American Academy of Actuaries
- Self-motivated with the ability to work both independently and with a team
- Strong verbal and written communication, problem-solving and analytical skills
- Effective time management skills
- Ability to apply actuarial concepts and calculations to diverse situations
- Advanced technical background with expertise in at least SQL, MS Excel, Access and Word
- Experience with SAS and VBA preferred