- Data Analysis Skills
To be fully engaged in providing Quality/No Harm, Customer Experience, and Financial Stewardship through statistical data analysis/support and construct probability tables to forecast risk and liability. Support product rate filings, reserve calculations, group underwriting and experience reporting to make product pricing decisions. Support the financial management of the health plan through medical cost and revenue projections predominantly through the use of Excel and SQL. Explain complex technical matters as needed.
Represent the System as necessary through community activities and participation in professional organizations.
Support and developed financial models for the monitoring and projection of current and future business.
Maintain rating models and data base support programs used in the Underwriting department
Develop and maintain models for the calculation of appropriate claims and other reserves.
Submit weekly report showing progress on current projects
Consistently seek ways to improve operational and financial efficiencies through better use of resources.
Contribute to development and maintenance of management reports necessary for the financial management of all products.
Support the development of required state and federal premium rate and other filings.
Assist in development and pricing of new products and product enhancements, including development of provider payment mechanisms.
Assist in the determination of premium rates required and cash reserves necessary to ensure payment of future benefits.
Support the design, review, and administration of health insurance plans, determine financial soundness and calculation of premiums.
Collaborate with Decision Support, Underwriters, Claims, and Senior Management to develop plans for new lines of business or improve existing business.
Ability to work extended hours as projects demand.
Able to work in often stressful environments, and maintain composure
Must exhibit superior analytical and problem solving abilities, to compile, categorize, and verify information.
Ability to prioritize and organize to maximize quality, value, and service.
BS or BA degree in Mathematics, Actuarial Science or related major from accredited college or university or currently enrolled as student and majoring in one of aforementioned programs.
3.4 GPA in college or university required.
Possess strong computer abilities with emphasis on Microsoft Excel, SQL or other programming language desired.
Sat for at least one actuarial exam.
Knowledge of laws, government regulations, and agency rules for managed care controls.
Some level of understanding of insurance and associated terminology.
Strong background in arithmetic, algebra, geometry, calculus, statistics, and their applications.
Knowledge of economics and accounting principles and practices, and reporting of financial data.
Knowledge of document structure and content, including spelling, grammar and rules of composition.