Senior Actuarial Analyst - Heath Plan

SCAN Group

$90K — $120K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • Bachelor's degree in Actuarial Science, Mathematics, or Statistics required.
  • 3+ years of experience in healthcare actuarial, economics, or finance; experience with provider contract modeling preferred.
  • Advanced analytical skills with proficiency in statistical and mathematical modeling.
  • Technical proficiency in Excel, SQL, and actuarial modeling software.
  • Strong communication skills to convey complex information to non-technical stakeholders.

Responsibilities

  • Prepare and analyze data for network contract modeling to support provider negotiations.
  • Develop financial analyses for fee-for-service negotiations incorporating Medicare structures.
  • Support ad-hoc analytics and customize projects based on business needs.
  • Assist in the development of Medicare Advantage bids by managing network assumptions.
  • Identify and implement opportunities for improving model efficiency and automation.
  • Foster a culture of curiosity and challenge conventional processes to enhance outcomes.
  • Support SCAN's Vision and Goals in all tasks and initiatives.

Benefits

  • Mostly remote work mode.
  • Annual employee bonus program.
  • Robust wellness program.
  • Generous paid time off (PTO) policy including 11 holidays and floating and birthday holidays.
  • Employee recognition program and tuition reimbursement.
  • 401(k) retirement savings plan with employer match.
Full Job Description
The Job

The Senior Actuarial Analyst contributes to the success of the Actuarial team by preparing and analyzing data for network contract modeling, identifying opportunities to improve model efficiency, and supporting effective communication with network team. Senior Actuarial Analysts typically have several years of experience in the field and may also be involved in mentoring and training junior analysts.

You Will
  • Use tools that currently exist support provider contract negotiations for globally capitated and shared risk providers. Support to include financial modeling, DOFR valuations (internal claims extraction / analysis and external research), health care cost trend, risk analysis, and advice / guidance to the Network Management and Contracting teams.
  • Develop ad hoc provider claims modeling and analysis for fee-for-service provider negotiations. Financial analyses may incorporate Medicare fee schedules and potentially repricing.
  • Support ad-hoc analytics such as product development, and other customized projects to suit business needs. Utilize the Data Warehouse efficiently to develop reports and extract data fields.
  • Assist the actuarial team with the development of Medicare Advantage bid by keeping track of network assumptions and scenarios.
  • Proactively identify opportunities to streamline workflows, enhance model efficiency, and improve automation of existing processes.
  • Bring intellectual curiosity and a continuous improvement mindset to all assigned work, challenging the status quo where appropriate.
  • We seek Rebels who are curious about AI and its power to transform how we operate and serve our members.
  • Actively support the achievement of SCAN's Vision and Goals.
  • Other duties as assigned.


Your Qualifications
  • Bachelor's Degree in Actuarial Science, Mathematics, or Statistics or any other major with significant quantitative course work is required.
  • 3+ years of healthcare actuarial, healthcare economic, or healthcare finance experience; or comparable consulting experiences. Experience with provider contract modeling and Medicare FFS structure. Certifications deemed to be reasonable to function at this level. Performs work under general supervision. Handles moderately complex issues and problems, and refers more complex issues to higher-level staff. Possesses solid working knowledge of subject matter. May provide leadership, coaching, and/or mentoring to a subordinate group.
  • Advanced Analytical Skills: Proficient in using statistical and mathematical models to analyze complex data sets, identify trends, and make informed predictions.
  • Technical Proficiency: Expertise in actuarial software and tools such as Excel, SQL, and specialized actuarial modeling software.
  • Communication and Collaboration: Strong ability to communicate technical information clearly to non-technical stakeholders and work effectively in cross-functional teams.
  • Microsoft Office Suite (Word, Excel including formulas, V-Lookups, and pivot tables, PowerPoint, Access, Outlook, Teams), and SQL at advance level is required.


What's in it for you?
  • Base salary range: $90,000 to $120,000 per year
  • Internal title: Actuarial Analyst Sr
  • Work Mode: Mostly Remote
  • An annual employee bonus program
  • Robust Wellness Program
  • Generous paid-time-off (PTO)
  • Eleven paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday
  • Excellent 401(k) Retirement Saving Plan with employer match and contribution
  • Robust employee recognition program
  • Tuition reimbursement
  • An opportunity to become part of a team that makes a difference to our members and our community every day!


We're always looking for talented people to join our team! Qualified applicants are encouraged to apply now!

At SCAN we believe that it is our business to improve the state of our world. Each of us has a responsibility to drive Equality in our communities and workplaces. We are committed to creating a workforce that reflects our community through inclusive programs and initiatives such as equal pay, employee resource groups, inclusive benefits, and more.

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