Actuarial Services Manager - Jefferson Health Plan

Number of Positions In Requisition

1

Job Details

The Actuarial Associate and Manager is responsible for supporting the Director of Actuarial Services in all phases of the Actuarial Department's needs. The Actuarial Associate and Manager will improve analytics and business decision support; improve information and processes in all aspects of the Medicaid and CHIP lines of business in addition to reserving, budgeting, forecasting, and regulatory filings. The Actuarial Associate and Manager will be actively involved individually and with other staff in the completion of different routine and ad-hoc analyses of an actuarial or financial nature under the guidance of the Director of Actuarial Services.

Job Description

• Estimate monthly IBNR and maintain & improve models and processes.
• Communicate results to management identifying any problem areas.
• Work closely with Utilization Management to identify and monitor potential large cases and estimate JHP27s potential liability.
• Financial reporting support.
• Financial budgeting and forecasting.
• Unit cost and utilization trend development and analysis.
• Actual vs expected analytics with analysis of variance.
• Risk pool and risk sharing estimation & analysis.
• Maintain and enhance internal data systems thru SQL.
• Prepare and validate various routine and ad hoc analyses to support the business decision process.
• Design and build models to support such analyses.
• Employ various data mining techniques.
• Function as an internal Medicaid actuarial point of contact between external auditors & consultants, and internal actuarial management.
• Support all state and federal regulatory reporting and filing requirements including but not limited to the annual CHIP rate filing.
• Support the ACA and Medicare lines of business as needed.
• Produce and maintain documentation of all routine and periodic processes.

Education and Experience:

• Bachelor27s Degree Actuarial Science, Mathematics, Statistics or other analytical field of study required
• 3 years Actuarial experience in Medicaid, health care data reporting and analysis required
• ASA - Associate of the Society of Actuaries - Society of Actuaries Required

Knowledge, Skills and Abilities - Required

• Ability to independently perform reasonability checks on completed work and recognize where further analysis is needed to understand and explain results
• Strong problem-solving, quantitative and analytical skills.
• Ability to use computer spreadsheet (Excel, VBA), database (Access and others) at advanced level to design and build reports & models.
• Self-motivated and able to juggle multiple priorities.

Knowledge, Skills and Abilities - Preferred

• Familiarity with SQL is a strong plus.

Work Shift

Workday Day (United States of America)

Worker Sub Type

Regular

Employee Entity

Health Partners Plans, Inc.

Primary Location Address

1101 Market, Philadelphia, Pennsylvania, United States of America

Benefits

Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts. Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service. All colleagues, including those who work less than part-time(including per diemcolleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.

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