ConnectiCare is a leading health plan in the state of Connecticut. ConnectiCare’s mission is to make it easy for members to get the care they need. A local company for over 35 years, ConnectiCare has a full range of products and services for businesses, municipalities, individuals and those who are Medicare-eligible. A subsidiary of EmblemHealth, ConnectiCare leads the individual and small group markets in the state, and is ranked among the top commercial health plans in the nation, according to the National Committee for Quality Assurance.
We’re looking for individuals who want to make a difference in the communities we serve. If you want to join a local team and help change the way health care is delivered, ConnectiCare is the place for you.
Perform high level actuarial analyses for both Commercial and Medicare business, including, but not limited to: valuation of actuarial liabilities, reserve (IBNR) development and analysis, medical expense analyses and projections, financial forecasts, regulatory rate filings, actuarial modeling, and ad hoc actuarial analyses/advice as needed.
- Build and utilize actuarially sound models to project monthly reserve (IBNR) levels, and otheractuarial liabilities.
- In conjunction with manager and other department staff, determine actuarially sound monthly accruals for actuarial liabilities, including but not limited to IBNR, Risk Adjustment, Reinsurance, Risk Corridors, CSR, MLR Rebates, provider liabilities, and arrangements such as CSEHRP and HRA.
- Monthly, analyze key product performance measures including, but not limited to, medical cost trends, emerging results and book-of-business loss ratios. Evaluate historical run-out patterns in IBNR, use to inform future valuations.
- Communicate drivers of medical results, variances to plan and forecast, and underlying trends to leadership to drive an understanding of monthly financial results and point out areas of concern where focus is needed.
- Provides monthly explanations and evaluation to financial team regarding comparisons to forecast for communication to relevant parties.
- Collaborate with Operations and Claim to understand impact on reserves of claim processing, emerging large claim activity, and project work
- Ensure appropriate financial entries are booked. Comply with all Model Audit controls and standards of practice.
- Annually review MAR Controls. Modify documentation as necessary to conform to changes in business practice, methodologies and responsibilities.
- Maintain documentation of compliance with all MAR controls. Support Internal Audit during annual MAR control audits.
- As primary point of contact, provide support to audits, statutory exams, and regulatory inquiries as needed.
- Quarterly, draft PDR Memo and Management Letter for review and signature of Chief Actuary.
- Apply sound actuarial principles to all analysis and to all aspects of decision-making processes.
- Demonstrate independent decision-making capability.
- Perform other related projects as needed.
TECHNICAL KNOWLEDGE, EXPERIENCE AND SKILL REQUIREMENTS:
- Bachelor’s degreerequired, preferably in Actuarial Science, Mathematics, Statistics, Finance, or related field, or an equivalent combination of education and experience.
- At least 5 years of previous experience in actuarial analysis required, preferably in a ManagedHealthcare environment.
- Excellent quantitative, problem solving, and analytical skills.
- Strong communication skills, both oral and written.
- Strong detail orientation.
- Ability to apply judgement and reasoning to find areas where results are inconsistent.
- Proficient with personal computers. Strong spreadsheet skills required; experience with Microsoft Access or similar query and report development software required. Ability to develop and built actuarial models is required.
ConnectiCare is an equal opportunity employer. M/F/D/V
Job Location Farmington, Connecticut, United States Position Type Full-Time/Regular Market Reference / Mid Point TBD
Tracking Code 17-141