Actuary Specialist - Actuarial Cost Insights (Remote)

UPMC Senior Communities • $110K — $130K *
Pittsburgh, PA 15237In-Person
Healthcare
5 - 7 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 required.
  • 7+ years of actuarial experience in health insurance, managed care or related consulting business.
  • Strong preference for experience with Power BI, claims-based analysis, trend analysis, population health, and network analysis.
  • In-depth understanding of health insurance market dynamics is essential.
  • Excellent problem-solving, analytical, oral, and written communication skills.

Responsibilities

  • Drive strategic decision-making around medical cost improvement strategies.
  • Lead development of financial tools that enhance corporate decision-making.
  • Oversee monthly Leading Indicator process and support timely clinical interventions.
  • Execute complex actuarial analyses translating business questions into insights.
  • Forecast financial results and identify medical cost improvement opportunities.
  • Use statistical software to analyze healthcare data and deliver actionable insights.
  • Cultivate cross-functional relationships to support data-based recommendations.

Benefits

  • Professional support for designations through a comprehensive student program.
  • Continuing education opportunities available.
  • Flexible work arrangements: fully remote or hybrid for Pittsburgh-based candidates.
  • Supportive environment for collaboration and team development.
Full Job Description
Purpose:
UPMC Health Plan is seeking an Actuary Specialist in its Department of Health Economics! This credentialed healthcare actuary would independently own and execute sophisticated actuarial analyses, apply industry expertise to identify opportunities, and influence strategic decisions around trend drivers. This includes leading the process of analyzing medical cost utilization and unit cost data, identifying top trend drivers and affordability opportunities, and frequently presenting findings to leadership.

The Actuary Specialist will require a diverse set of skills and experience, including data and analytics expertise, broad-based business and health economics acumen, a strategic mindset, and an ability to influence and leverage cross-functional teams in a non-traditional actuarial environment. This position may also direct or supervise less experienced actuarial analysts in the performance of duties.

As an Actuary at UPMC, you will be given support for professional designations through our comprehensive student program and continuing education opportunities. Our team members can choose a work style that is best for them - this position is eligible for fully remote work or a hybrid work arrangement for candidates based in Pittsburgh, PA.

Responsibilities:

  • Drive creative problem-solving and strategic decision-making involving medical cost improvement strategies.
  • Lead the development of detailed actuarial and financial tools to communicate drivers of financial performance to facilitate corporate decision-making and the development of cost mitigation strategies.
  • Lead the monthly Leading Indicator process detailing emerging results and present results to clinical teams to support timely intervention and decision-making.
  • Independently lead the design, development, and execution of complex actuarial analyses that translate business questions into actionable insights and strategic recommendations.
  • Lead the analysis for analyzing the impacts of healthcare affordability initiatives on medical cost and utilization trends.
  • Apply analytical and statistical software tools to summarize large healthcare data to glean findings and actionable insights and deliver results to leadership.
  • Forecast and interpret financial results, including variances from budget, to help identify medical cost improvement opportunities and potential risks.
  • Analyze trends in spending and utilization using healthcare claims data.
  • Develop and gain support for data-based recommendations with team members from product, clinical, network, and strategy functions.
  • Lead the development of well-documented standard actuarial reports and projects.
  • Frequently present results of analyses and recommendations to management and senior leaders and lead the completion of follow-ups and next steps.
  • 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.
  • Provide direction and supervision to less experienced staff in the performance of duties. May directly manage 1 analyst.
  • Build strong relationships with Actuarial, Analytics, and Finance teams across the enterprise.
  • Ensure that departmental work products meet the highest standards of quality.


Qualifications:

  • Bachelor's degree in mathematics, statistics, actuarial science, economics or related field required.
  • 7+ years of experience in actuarial work in a health insurance, managed care or related consulting business; or equivalent training, education and/or experience.
  • Experience in any of the following is a strong preference: Power BI, claims-based experience analysis, trend analysis, population health, network and reimbursement analysis.
  • Experience with commercial and government health programs is preferred.
  • In-depth understanding of health insurance market dynamics.
  • Excellent problem solving and analytical skills.
  • Excellent oral and written communication skills.
  • Strong PC skills.
  • Adaptability and ability to prioritize effectively
  • Data retrieval skills and relational database experience required, including SQL and/or SAS.
  • Data visualization experience is preferred.

    Licensure, Certifications, and Clearances:
  • A.S.A. or F.S.A. certification by Society of Actuaries Membership in the American Academy of Actuaries

About UPMC Senior Communities

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There has never been a better time to explore the diverse job opportunities at UPMC Senior Communities—the leading network of senior living facilities focused on innovative care and professional excellence.

Work You’ll Do

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.

Introducing the UPMC Senior Communities Professional Development Program

The program is designed to foster career growth through comprehensive training, leadership development, and diversity training. UPMC Senior Communities is committed to nurturing the professional growth of its team members through continuous education and opportunities for advancement.

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Be part of a culture that thrives on innovation and continuous improvement. UPMC Senior Communities employs a vast array of healthcare professionals and support staff, all dedicated to setting new standards in senior care.

Drive Change in Senior Healthcare

Deliver targeted solutions and personalized care that significantly improve the quality of life for residents. UPMC Senior Communities offers a platform for professionals to apply their expertise in a meaningful and impactful way.

Be Part of a Great Team

Work alongside a team that values compassion and professionalism, harnessing the collective capabilities to deliver exceptional care. UPMC Senior Communities promotes a collaborative environment where every team member’s contribution is valued.

Future-Proof Your Career

Advance your career within UPMC Senior Communities through a variety of pathways, from direct care positions to administrative roles. Enjoy robust benefits, professional development programs, and a supportive work environment that encourages long-term career growth.

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Discover how UPMC Senior Communities leads the way in senior healthcare innovation: - Implementing cutting-edge health technology to enhance resident care - Developing community-based programs that support holistic wellness

The UPMC Senior Communities Employment Promise

With a commitment to employee satisfaction and career development, UPMC Senior Communities ensures that all team members have the resources and support to succeed. Clients and their families rely on UPMC Senior Communities for compassionate and skilled care, making it a prime choice for those seeking meaningful employment in the healthcare sector.

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* Ladders Estimates

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