Job Information
UPMC Actuary Lead- Value Based Contracting (Remote, US) in Pittsburgh, Pennsylvania
UPMC Health Plan has an exciting opportunity for an Actuary Lead on their rockstar Value-Based Contracting Team!
This position applies knowledge of mathematics, probability, and statistics in order to identify issues and gather and analyze data on a wide variety of topics affecting the financial performance of the health plan. Ensure timely and accurate services to clients. Supports strong internal and external relationships.
Preferences:
Working experience in SQL and Excel
Experience following fields: value-based contracting, pricing, reserving, trend/health economics, provider network analysis, risk adjustment, etc
FSA or ASA
This role can be remote anywhere within the US!
Responsibilities:
Presents results of analyses and recommendations to actuarial management.
Develop junior actuarial department staff
Support the Medicare Bid process, including preparing presentations, providing all requested reports and pricing, responding to desk review queries, and working with other departments to file all bids in a timely manner
Responsible for the preparation of financial analyses in support of the following functions: Medical cost and utilization trend analysis; Forecasting; - Provide analytical support for rate development and filings; - Provide ad hoc data analysis to all departments within the company.
Documents methods, procedures and results.
Provide actuarial support and requests for the annual CMS Financial Audits; communicate with auditors when needed
Will direct junior actuarial department personnel in the performance of duties.
Price, analyze, and assign annual premium increases/decreases to Medicare Employer Groups; includes communication with product development/ sales and the ability to explain pricing decisions to senior management
Review of other's work product.
Prepares and reviews Medicare Bid Submissions.
Responsible for the development of mathematical models in connection with other departments to predict the impact of proposed changes.
Will own project management of projects, including deliverables and appropriate work.
Bachelor's degree in mathematics, statistics, actuarial science, economics, or related field
Five plus years of experience in actuarial work in health insurance, managed care or related consulting business; or equivalent training, education, and/or experience.
Excellent problem-solving and analytical skills.
In-depth understanding of health insurance market dynamics.
ASA certification at minimum
Licensure, Certifications, and Clearances:
ASA certification, min
Act 34
UPMC is an Equal Opportunity Employer/Disability/Veteran
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