Job Requirements

POSITION SUMMARY:

To be fully engaged in providing Uncompromised Safety, Superior Quality, Memorable patient/Customer Experiences, and Financial Stewardship by providing statistical data analysis/support and construct probability tables to forecast risk and liability. Support product rate filings, reserve calculations, group underwriting and experience reporting, to make price decisions. Support the financial management of the health plan through medical cost and revenue projections predominantly through the use of Excel. Explain complex technical matters as needed.

PRIMARY ACCOUNTABILITIES:

Engagement:

Represent the System as necessary through community activities and participation in professional organizations.

Quality/No Harm:

Support and developed financial models for the monitoring and projection of current and future business.
Maintain rating models and data base support programs used in the Underwriting department.
Develop and maintain models for the calculation of appropriate claims and other reserves.
Submit weekly report showing progress on current projects

Customer Experience:

Demonstrate dependability, flexibility and a high level of job interest.
Consistently seek ways to improve operational and financial efficiencies through better use of resources.
Contribute to development and maintenance of management reports necessary for the financial management of all products.

Stewardship:

Filing Support: support the development of required state and federal premium rates and other filings.
Product Support: assist in development and pricing of new products and product enhancements. Collaborate with Decision Support, Underwriters, Claims, and Senior Management to develop plans for new lines of business or improve existing business.
Financial Support: assist in the determination of cash reserves (IBNR), risk funding mechanisms (SSA, 3-R's, etc.), budget projections, and all other financial modeling including development of provider payment mechanisms.
Group Services Support: support the design, review, administration, and regulatory compliance of health insurance plans in the delivery to specific employer groups.
Underwriting Support: assist in development and pricing of existing and proposed Large Group business including support of pricing models.
Will provide lead responsibilities and be considered a Subject Matter Expert in at least one of the above disciplines: Filing, Product, Financial, Group Services, or Underwriting.

Work Experience

QUALIFICATIONS REQUIRED:

BS or BA degree in Mathematics or Actuarial Science from accredited college or university..
3.4 GPA in college or university required.
Possess strong computer abilities with emphasis on Microsoft Excel, SQL or other programming language desired.
Passed three actuarial exams
Knowledge of laws, government regulations, and agency rules for managed care controls.
Some level of understanding of insurance and associated terminology.
Strong background in arithmetic, algebra, geometry, calculus, statistics, and their applications.
Knowledge of economics and accounting principles and practices, and reporting of financial data.
Knowledge of document structure and content, including spelling, grammar and rules of composition.
Be able to perform support tasks autonomously for at least one of the following responsibilities as described above: Filing, Financial, Group Services, or Underwriting.
Has demonstrated an ability to work directly with Underwriting, Risk Adjustment, Finance, Decision Support, Group Services and/or Senior Management.
Minimum of 2 years of experience in at least one of the following support responsibilities as described above: Filing, Financial, Product, Group Services, or Underwriting.

PHYSICAL DEMANDS:

Able to sit and view computer screen for up to three hours at a time to enter data and set up functions.
Ability to work extended hours as projects demand.
Ability to occasionally stand; walk; use hands to handle or feel; and reach with hands and arms.
Able to frequently lift and/or move up to 25 pounds.

MENTAL DEMANDS:

Able to work in often stressful environments, and maintain composure.
Must exhibit superior analytical and problem solving abilities, to compile, categorize, and verify information.
Ability to prioritize and organize to maximize quality, value, and service.

Benefits

At Health First, diversity and inclusion are essential for our continued growth and evolution. Working together, we strive to build and nurture a culture that recognizes, encourages, and respects the diverse voices of our associates. We know through experience that different ideas, perspectives, and backgrounds create a stronger and more collaborative work environment that delivers better results. As an organization, it fuels our innovation and connects us closer to our associates, customers, and the communities we serve.

Schedule : Full-Time

Shift Times : 800am_500pm

Paygrade : AA4

HEALTH FIRST CAREERSVerified Employer

Company Stats

Open Roles

Senior Actuarial Analyst - Actuarial and Underwriting (must reside in Florida)

Actuarial Analyst II Health Plans (must reside in Florida)