Actuarial Analyst II
Company: Sentara Health
Location: Gainesville
Posted on: April 17, 2024
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Job Description:
City/State
Gainesville, FL
Overview
Work Shift
First (Days) (United States of America)
AvMed, a division of Sentara Health Plans in the Florida market, is
hiring an Actuarial Analyst II in Miami or Gainesville Florida.
This is a hybrid position, 2 days in office and 3 days remote if
within local market or 100% remote if outside of local
territory.
Scope of the position: Assist in any and all of the functions
normally associated with a qualified health actuary including: IBNR
calculation; the determination of rating factors such as age, sex,
location, or industry; development of rates and filings for the OIR
; suggestions for periodic group rating changes; development of
necessary rates for government programs; assistance with the
development, implementation and maintenance of new products,
services and systems, including any necessary rate development;
providing actuarial input to the Corporate management staff level;
and reporting on the financial status of entire products or
segments of products.
ESSENTIAL JOB FUNCTIONS:
Assists in and takes ownership of the assessment of feasibility,
anti-selection risk, marketability, alternative product options,
existing product options, improvements, market needs, configuration
issues, and portfolio placement of new products.
Develops and analyzes financial projections.
Assists in and takes ownership of the development of risk
adjustment projections for both the Commercial and Medicare product
line.
Provides assistance to underwriters and marketing in valuing groups
benefit changes.
Interacts with consulting actuaries in the production and review of
regulatory filings and related analyses.
Assists and participates in negotiations and sales presentations
with customers where appropriate.
Researches, evaluates and analyzes medical care costs trends by
region, market segment and product line and conduct variance
analysis with respect to utilization and unit costs.
Provides support in the development of operational systems and
reporting tools for use by the Commercial Group Underwriting Unit
to include automated excel-based rating programs and other
actuarial tools used within the department.
Assists in and takes the ownership of the development of
underwriting guidelines and policies conducive to profitability and
the avoidance of adverse selection.
Assists in and takes the ownership of the unit Manager with the
coordination of all regulatory audit activities for the
Underwriting and Financial Department, including DFS Market Conduct
Exams, Medicare ACR audit and OPM audit.
Performs additional duties and responsibilities as assigned by
management
Minimum Requirements:
Bachelors Mathematics, Economics, Actuarial Services or related
field.
Minimum 2 years in Actuarial Analysis. Analytical and
problem-solving skills are necessary; ability to work under tight
deadlines and handle pressure situations; ability to work in a team
environment.
Minimum completion of three Actuarial exams with continued progress
towards Society of Actuaries credential.
Experience in at least 3 of the following areas:
- IBNR and reserve setting
- General pricing and filing support of Individual products
- General pricing and filing support of Small Group products
- General pricing and filing support of Large Group products
- Assist in Medicare Advantage Bid filing
- Evaluation of Managed Medicaid programs
- Provider Contract evaluations
- Provider Profit/withhold settlement evaluations
- Product Experience Monitoring
- Reinsurance/Stop-loss Reporting
2 to 3 years of Experience working with risk models, mathematical
or actuarial analysis, preferably in a health insurance field.
Successful completion of at least three Society of Actuaries
examination required.
Preferred Requirements:
Automated or Statistical Analysis Tools
Microsoft Office Suite (Excel, Word, PowerPoint, Access)
Analytical and Problem Solving
This position is 100% Remote but candidates must have a current
residence in one of the following States or be willing to relocate-
Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas,
Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New
Hampshire, North Dakota, Ohio, Oklahoma, Pennsylvania, South
Carolina, South Dakota, Tennessee, Texas, Utah, Washington (state),
West Virginia, Wisconsin, Wyoming
Our Benefits:
As the third-largest employer in Virginia, Sentara Health was named
by Forbes Magazine as one of America's best large employers. We
offer a variety of amenities to our employees, including, but not
limited to:
Medical, Dental, and Vision Insurance
Paid Annual Leave, Sick Leave
Flexible Spending Accounts
Retirement funds with matching contribution
Supplemental insurance policies, including legal, Life Insurance
and AD&D among others
Work Perks program including discounted movie and theme park
tickets among other great deals
Opportunities for further advancement within our organization
Sentara employees strive to make our communities healthier places
to live. We're setting the standard for medical excellence within a
vibrant, creative, and highly productive workplace. For information
about our employee benefits, please visit: Benefits - Sentara
(sentaracareers.com)
Join our team! We are committed to quality healthcare, improving
health every day, and provide the opportunity for training,
development, and growth!
Note: Sentara Healthcare offers employees comprehensive health care
and retirement benefits designed with you and your family's
well-being in mind. Our benefits packages are designed to change
with you by meeting your needs now and anticipating what comes
next. You have a variety of options for medical, dental and vision
insurance, life insurance, disability, and voluntary benefits as
well as Paid Time Off in the form of sick time, vacation time and
paid parental leave. Team Members have the opportunity to earn an
annual flat amount Bonus payment if established system and employee
eligibility criteria is met.
Keywords: Talroo-health Plan, #Indeed, Risk Models, Pricing, Health
Insurance
Job Summary
Assist in any and all of the functions normally associated with a
qualified health actuary including: IBNR calculation; the
determination of rating factors such as age, sex, location, or
industry; development of rates and filings for the BOI; suggestions
for periodic group rating changes; development of necessary rates
for government programs; assistance with the development,
implementation and maintenance of new products, services and
systems, including any necessary rate development; providing
actuarial input to the Corporate management staff level; and
reporting on the financial status of entire products or segments of
products.
Minimum 2 years in Actuarial Analysis. Analytical and
problem-solving skills are necessary; ability to work under tight
deadlines and handle pressure situations; ability to work in a team
environment. Minimum completion of three Actuarial exams with
continued progress towards Society of Actuaries credential.
Experience in at least 3 of the following areas:
- IBNR and reserve setting
- General pricing and filing support of Individual products
- General pricing and filing support of Small Group products
- General pricing and filing support of Large Group products
- Assist in Medicare Advantage Bid filing
- Evaluation of Managed Medicaid programs
- Provider Contract evaluations
- Provider Profit/withhold settlement evaluations
- Product Experience Monitoring
- Reinsurance/Stop-loss Reporting
Qualifications:
BLD - Bachelor's Level Degree (Required)
Skills
Sentara Healthcare prides itself on the diversity and inclusiveness
of its close to an almost 30,000-member workforce. Diversity,
inclusion, and belonging is a guiding principle of the organization
to ensure its workforce reflects the communities it serves.
Per Clinical Laboratory Improvement Amendments (CLIA), some
clinical environments require proof of education; these regulations
are posted at ecfr.gov for further information. In an effort to
expedite this verification requirement, we encourage you to upload
your diploma or transcript at time of application.
In support of our mission to improve health every day, this is a
tobacco-free environment. Associated topics: actuarial consultant,
actuary, analyst, cost, director actuary, mathmatics, model,
probability, retirement actuary, statistics
Keywords: Sentara Health, Gainesville , Actuarial Analyst II, Professions , Gainesville, Florida
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