For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.
Your career starts now. We are looking for the next generation of health care leaders.
At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we would like to connect with you.
Headquartered in Newtown Square, Pennsylvania, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.
Discover more about us at www.amerihealthcaritas.com.
Work Arrangement:
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Remote within the United States
Role Overview:
The Senior Actuarial Analyst will collaborate with team members and other stakeholders toward delivering needed actuarial services to the organization. Will work within one of three types of teams with the following responsibilities:
Medicaid Markets
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Calculates, monitors, and assesses impact of fee schedule changes, program changes, base data changes, and enrollment mix changes over the rate life cycle.
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Develops and maintains spreadsheets and databases for purposes of trend and data analytics.
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Performs monthly data analysis projects to assist senior analysts.
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Assists in updating forecasting models for reforecasts and expected budgets.
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Prepares internal and external communications, including that with regulatory authorities and internal management.
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Uses best practice models and other industry recognized pricing tools.
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Applies actuarial principles in the performance of job responsibilities.
Valuation Teams
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Updates monthly reserve model, reviewing specifics of IBNR calculations with either senior analyst or manager for assigned lines of business.
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Performs monthly calculation of LOB membership and revenue.
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Reports LOB reserves and revenue to accounting for monthly financial reporting.
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Prepares summaries of revenue and reserves for LOB finance directors and upper management.
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Fulfills monthly, quarterly, and ad hoc state reporting requests that involve reserves, revenue, or medical loss ratio.
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Assists in the preparation of actuarial opinions and memorandum.
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Uses best practice models and other industry recognized pricing tools.
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Applies actuarial principles in the performance of job responsibilities.
Analytics Teams
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Performs medical cost projections for the annual budget process.
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Assists in developing cost projections for contract period negotiations.
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Tracks experience against initial budget projections/expenses.
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Develops revenue models as part of the monthly financial reporting package – has a clear understanding of the rate cells by LOB, stratification of current vs. retroactive members, revenue changes by month etc.
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Clearly demonstrates an understanding of the base revenue from other pass-throughs or at-risk components of the base cap.
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Can capture maternity and newborn kick as part of the revenue and submission process.
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Assists in the preparation of actuarial memorandums for filing with the state and other outside agencies.
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Prepares internal and external communications, including that with regulatory authorities and internal management.
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Uses best practice models and other industry recognized pricing tools.
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Applies actuarial principles in the performance of job responsibilities.
Experience/Education:
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Bachelor's degree in Actuarial Science, Mathematics, Statistics, or related field
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2-5 actuarial exams
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Strong knowledge of Excel, SAS/SQL, and database applications used for analysis
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Programming experience in Python or R is a plus
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Strong project management skills
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Strong ability to work on a team/communicate effectively
Our Comprehensive Benefits Package
Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.
