Actuarial Analyst - II/III/IV
Company: Excellus
Location: Rochester
Posted on: May 17, 2022
Job Description:
Job Details Description SummaryUnder general supervision, the
Actuarial Analyst performs actuarial services in support of Health
Plan operations and monitors and maintains financial solvency
through the understanding of current data & environment and
modeling of future events. Interacts with internal and external
departments such as Rating & Underwriting, Finance, Network
Management, Provider Contracting, Health Informatics, Marketing &
Sales as well as BCBSA, NYSID and CMS. Establishes insurance rates,
rating structures, and rating systems for groups and categories of
business. Maintains reserve programs, pricing files, benefit
relativity tables and appropriate documentation for work. Develops
financial projections, unpaid claim liability estimates and
conducts actuarial analysis for well defined projects as directed.
Compiles and analyzes data to draw conclusions and make
recommendations. Proposes and assists in the development of process
improvements utilizing system and software applications to full
potential and participates in activities and projects as directed.
Essential Responsibilities/AccountabilitiesAll LevelsLevel I
- Develops rate or Medicare bid filings through analysis of
benefit designs, claims experience, and expected future
events.
- Prepares accurate and timely trend analyses for lines of
business.
- Develops preliminary reserve estimates for one or more blocks
of business.
- Prepares data used to analyze unpaid claim liabilities for
various NAIC, NYS and internal financial statements.
- Prepares and submits financial blanks and other regulatory
reports required by the NAIC, NYS or BCBSA.
- Participates in regulatory/external party audits.
- Supports analysis of regulatory changes in determination of the
Health Plan impact.
- Assists in the preparation of risk adjustment analyses.
- Supports higher level analysts on special projects involving
other areas of the company.
- Supports analyses for other departments on various
initiatives.
- Assists in performing analyses used in the development of
financial plans, re-forecasts, and other financial
projections.
- Assists in efforts to continually improve data capabilities and
quality of department analysis and reporting.
- Assists in the development of rates, rating factors, rate
filings and other rating related responsibilities.
- Assists in the implementation of regional or product line
initiatives.
- Identifies, participates in and/or implements process
improvement initiatives.
- Prepares and/or maintains appropriate documentation of
work.
- Completes and/or supports ad hoc analyses and projects and
assists others in the department as needed.
- Supports risk sharing analyses, capitation development, and
associated settlements.
- Consistently demonstrates high standards of integrity by
supporting the Lifetime Healthcare Companies' mission and values,
adhering to the Corporate Code of Conduct, and leading to the
Lifetime Way values and beliefs.
- Maintains high regard for member privacy in accordance with the
corporate privacy policies and procedures.
- Regular and reliable attendance is expected and required.
- Performs other functions as assigned by management. Level II
(in addition to Level I essential
responsibilities/accountabilities):
- Shares knowledge with newer department employees.
- Conducts analyses for other departments on various
initiatives.
- Assists the development of actuarial analyses concerning
complex issues & trends, coordinates with staff.
- Analyzes and recommends reserves for one or more blocks of
business.
- Identifies and develops corrective action with regards to Data
Warehouse integrity issues.
- Reconciles Data Warehouse data with corporate financials.
- Initiates and leads efforts to continually improve data
capabilities and quality of department analysis and reporting.
- Draws together facts and input from a variety of sources.
- Develops analyses as assigned. Level III (in addition to Level
II essential responsibilities/accountabilities):
- Ensures pricing is consistent with established profitability
targets for business segments priced in Actuarial.
- Develops rates, rating factors and rate filings. Maintain
rating methods and models or formulas for Commercial and Medicare
lines of business.
- Recommends reserves for several blocks of business. Provide and
explain analysis supporting recommendation.
- Develops actuarial analyses concerning complex issues and
trends, coordinating with several different disciplines and
staff.
- Provides effective technical advice and support to assist
management in meeting corporate goals and identifying strategy.
Involves other departmental areas as needed.
- May prepare actuarial statements of opinion. Level IV (in
addition to Level III essential
responsibilities/accountabilities):
- Recommends departmental annual performance goals.
- Represents the Actuarial Department on special projects
involving other areas of the company or external constituents.
- Leads actuarial analyses concerning complex issues and trends,
coordinating with several different disciplines and staff.
- Interprets how regulatory changes affect Health Plan and
develops impact analyses.
- Provides support to assist management in meeting corporate
goals and strategic decision making. Minimum Qualifications:NOTEWe
include multiple levels of classification differentiated by
demonstrated knowledge, skills, and the ability to manage
increasingly independent and/or complex assignments, broader
responsibility, additional decision making, and in some cases,
becoming a resource to others. In addition to using this
differentiated approach to place new hires, it also provides
guideposts for employee development and promotional
opportunities.All LevelsLevel I
- BS in Math, Economics, Actuarial Science or allied field with a
minimum one year of actuarial experience required or in lieu of
experience, at least one actuarial exam is required.
- Continued professional growth in Actuarial field as evidenced
by participation in the Actuarial Study Program.
- Strong analytical skills, verbal and written communication
skills.
- Strong interpersonal skills, including negotiation skills.
- Strong organizational skills and ability to prioritize,
multitask, and work in fast paced environment.
- A strong understanding of health insurance & health insurance
products, managed care, accounting principles, the competitive
market, the legislative environment, and any regulatory issue
affecting the Health Plan is expected to be acquired.
- Strong PC skills including proficiency in Microsoft Excel,
Word, SAS, Cognos, and Power Point required.
- Proficiency using Milliman USA Health Cost Guidelines may be
required; if so, training will be provided where necessary. Level
II (in addition to Level I minimum qualifications):A minimum
of:
- Three years actuarial or related insurance industry experience
required or
- Two years actuarial or related insurance industry experience
and two actuarial exams required.
- Highly proficient computer skills including Excel, Word, SAS,
Cognos, PowerPoint
- High level understanding of non-Actuarial functions such as
Rating, Underwriting, Accounting, Provider Contracting, Network
Management, Product Development, Medical Management, etc., and how
they impact Health Plan operations and financials. Level III (in
addition to Level II minimum qualifications):A minimum of:
- Six years actuarial or related insurance industry experience
required or
- Three years actuarial or related insurance industry experience
and four actuarial exams is required.
- Strong ability to recognize and automate repetitive tasks
- Ability to perform complex modeling independently Level IV (in
addition to Level III minimum qualifications):A minimum of:
- Ten years actuarial or related insurance industry experience
required or
- Four years actuarial or related insurance industry experience
and ASA & MAAA credentials.
- A strong understanding of non-Actuarial functions such as
Rating, Underwriting, Accounting, Provider Contracting, Network
Management, Product Development, Medical Management, etc., and how
they impact Health Plan operations and financials. Physical
Requirements The Lifetime Healthcare Companies aims to attract the
best talent from diverse socioeconomic, cultural and experiential
backgrounds, to diversify our workforce and best reflect the
communities we serve. Our mission is to foster an environment where
diversity and inclusion are explicitly recognized as fundamental
parts of our organizational culture. We believe that diversity of
thought and background drives innovation which enables us to
provide leading-edge healthcare insurance and services. With that
mission in mind, we recruit the best candidates from all
communities, to diversify and strengthen our workforce. OUR COMPANY
CULTURE:Employees are united by our Lifetime Way Values & Behaviors
that include compassion, pride, excellence, innovation and having
fun! We aim to be an employer of choice by valuing workforce
diversity, innovative thinking, employee development, and by
offering competitive compensation and benefits. In support of the
Americans with Disabilities Act, this job description lists only
those responsibilities and qualifications deemed essential to the
position. Equal Opportunity Employer Qualifications Skills
Behaviors : Motivations : Education Preferred Bachelors or better
in Actuarial Science. Bachelors or better in Mathematics.
Experience Licenses & Certifications Equal Opportunity
Employer/Protected Veterans/Individuals with Disabilities
Keywords: Excellus, Rochester , Actuarial Analyst - II/III/IV, Professions , Rochester, New York
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