Actuarial Analyst III, Value-Based Contract Analytics (Remote)

UPMC Senior Communities • $85K — $100K *
US-AnywhereRemote in Pittsburgh, PA
Healthcare
Less than 5 years of experience
Today
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Job Overview by Ladders

Qualifications

  • Bachelor's degree in mathematics, statistics, actuarial science, economics or related field.
  • 3-5 years of experience in actuarial work in a health insurance or managed care environment.
  • Actively pursuing ASA and/or FSA certification by the Society of Actuaries.
  • 4 or more actuarial examinations passed.
  • Completion of Validation by Education Experience (VEE) credits or comparable college courses preferred.
  • Excellent analytical and problem-solving skills.
  • Strong oral and written communication skills.
  • Proficient in Microsoft Office Suite and SQL/SAS.

Responsibilities

  • Produce detailed actuarial and financial models to project performance for value-based programs.
  • Analyze healthcare claims to identify trends for various payment arrangements.
  • Apply analytical software to summarize healthcare data for actionable insights.
  • Forecast financial results and identify cost improvement opportunities.
  • Develop data-driven recommendations across multiple functions.
  • Produce thorough actuarial reports and documentation.
  • Present analysis results and recommendations to leadership.
  • Collaborate with various teams to ensure quality in work products.

Benefits

  • Support for professional designations through a comprehensive student program.
  • Work-from-home opportunity available within the continental US.
Full Job Description
Purpose:
The Department of Health Economics is seeking an Actuarial Analyst III. This experienced healthcare actuarial analyst would help drive high-visibility impactful analysis supporting medical cost improvement strategies for UPMC Health Plan. This includes analyzing medical cost utilization and unit cost data, identifying top trend drivers and affordability opportunities, developing and evaluating financial outcomes of value-based programs and presenting findings to leadership. This position may also direct or supervise less experienced actuarial students in the performance of duties.

The Actuarial Analyst III will require a diverse set of skills, including strong communication skills, sharp critical thinking abilities, and a curiosity for health economics and data analytics.

As an Actuarial Analyst III at UPMC, you will be given support to reach professional designations through our comprehensive student program. This is a work-from-home position located anywhere within the continental US.

Responsibilities:

  • Produce detailed actuarial and financial models which communicate near and long-term projections of financial performance of new and ongoing value-based programs to facilitate corporate decision-making and the development of strategies and goals.
  • Analyze healthcare claims cost and utilization trends for use in projections defining savings methodologies for provider arrangements such as ACO & PCMH contracts, global capitation, bundled rates, episodic payments, capitation, risk adjusted total cost of care, and value-based payments.
  • Apply analytical and statistical software tools to summarize large healthcare data to glean findings and actionable insights.
  • Forecast and interpret financial results, including variances from budget, to help identify medical cost improvement opportunities and potential risks as an individual or leading other analysts.
  • Develop and gain support for data-based recommendations with team members from product, clinical, network, and strategy functions.
  • Produce well-documented standard actuarial reports and projects.
  • Present results of analyses and recommendations to leadership.
  • Apply an understanding of complex actuarial concepts, methods, and applications in a variety of situations.
  • Creatively leverage a wide range of datasets to inform key analyses.
  • Collaborate with team members, including other healthcare actuaries, to ensure that work product meets the highest standards of quality.
  • Build strong relationships with Actuarial, Analytics, Reimbursement, Clinical, and Finance teams across the enterprise.
  • Provide analytical support for ad hoc data analyses.


Qualifications:

  • Bachelor's degree in mathematics, statistics, actuarial science, economics or related field.
  • 3-5 years of experience in actuarial work in a health insurance, managed care or related consulting business.
  • Actively pursuing the ASA and/or FSA certification by Society of Actuaries.
  • 4 or more actuarial examinations passed.
  • Completion of Validation by Education Experience (VEE) credits or comparable college-level courses on micro and macroeconomics, introductory corporate finance, and applied statistical methods are preferred.
  • Excellent problem solving and analytical skills.
  • Excellent oral and written communication skills.
  • Strong PC skills, including experience in Microsoft Office Suite (Word, Excel, PowerPoint).
  • Data retrieval skills and relational database experience required, including SQL and/or SAS.
  • Ability to work independently.
    Licensure, Certifications, and Clearances:
  • Act 34

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Join UPMC Senior Communities to assist in transforming the experience of aging through top-tier care and wellness programs. This is an opportunity to be part of a team that values leadership, diversity, and innovation in the healthcare sector. Lead in a unique role where skills in healthcare, empathy, and leadership converge to enhance the lives of seniors. UPMC Senior Communities stands at the forefront of the industry, integrating advanced technology and personalized care practices. Engage with a professional network of healthcare providers and administrators dedicated to pioneering improvements in senior living. Collaborate with over 3,000 dedicated professionals across various facilities.

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