This position applies knowledge of mathematics, probability, and statistics in order to identify issues, and gather and analyze data on a wide variety of topics affecting the financial performance of the health plan May represent the department on corporate projects. Receives assistance from either management or senior positions when necessary.
The Medicare Actuarial Team supports one of the top Medicare Advantage plans in the country. Everchanging regulations offer a flexible and dynamic work environment and require collaboration with a variety of teams in the healthcare space. Our team is highly visible within the company and offers many opportunities to grow your skillset.
Preferences:
- Medicare bid experience, pricing experience, strong Excel/SQL skills, risk score experience, model building, trend experience, CMS audit experience
Although an individual local to Pittsburgh for a hybrid work arrangement is preferred, this role can be remote anywhere within the US!
UPMC is being recognized as one of the best places to work in the country. Forbes' list of America's Best Employers by State included UPMC as one of the best employers in the state of Pennsylvania!
*The survey by Forbes and Statista included responses from more than 70,000 workers at companies across the country. Respondents were asked about working conditions, compensation, diversity, and potential for advancement. They were also asked if they would recommend their employer to others.
10 Stand-Out Benefits that UPMC Employees Enjoy
Responsibilities:
- Responsible for the development of mathematical models in connection with other departments to predict the impact of proposed changes.
- Reports to head of actuarial department or Actuarial Manager.
- Presents results of analyses and recommendations to management.
- Documents methods, procedures and results.
- Preparation of State and Federal filings. Including Federal Exchange, Pennsylvania Insurance Department Filings and Medicare Bid Submissions.
- Will own project management of projects, including deliverables and appropriate work.
- Will direct and supervise junior actuarial department personnel in the performance of duties.
- Responsible for the preparation of financial analyses in support of the following functions: Medical cost and utilization trend analysis; Forecasting; - Development of claim reserves (IBNR) - Completion factors using claim lag analysis models; - Provide analytical support for rate development and filings; - Provide ad hoc data analysis to all departments within the company.- Review of other's work product.
Qualifications:
- Bachelor's degree in mathematics, statistics, actuarial science, economics, or related field and 5+ years of experience in actuarial work in a health insurance, managed care, or related consulting business;
- or equivalent training, education, and/or experience.
- ASA certification
- Medicare bid experience, pricing experience, strong Excel/SQL skills, risk score experience, model building, trend experience, CMS audit experience
- Excellent problem solving and analytical skills.
- Good oral and written communication skills.
- Strong PC skills.
- Data retrieval skills and relational database experience.
- Works independently.
Licensure, Certifications, and Clearances:
A.S.A. or F.S.A. certification by Society of Actuaries Membership in the American Academy of Actuaries
A.S.A. or F.S.A. certification by Society of Actuaries Membership in the American Academy of Actuaries - Act 34
UPMC is an Equal Opportunity Employer/Disability/Veteran
Working at
UPMC Senior Communities
UPMC Senior Communities is a reputable and leading provider of senior living and healthcare services. With a strong commitment to exceptional care, UPMC Senior Communities offers a range of options including independent living, assisted living, and memory care. As an actuary at UPMC Senior Communities, you'll be part of a dedicated team that plays a crucial role in managing risks and ensuring the financial stability of the organization. Actuaries utilize their expertise in statistical modeling, data analysis, and risk assessment to evaluate risks, develop pricing strategies, and provide insights that support evidence-based decision-making. Collaborating with cross-functional teams, actuaries at UPMC Senior Communities contribute their analytical skills to optimize financial resources, forecast trends, and develop strategies that enhance the financial health of the organization. Actuaries analyze complex data sets, assess risks, and provide recommendations that help in providing quality care to seniors while maintaining a sustainable financial model. UPMC Senior Communities values professional growth and offers ongoing training and development opportunities for actuaries. Actuaries have the chance to enhance their skills, stay up to date with industry advancements, and contribute to the success of providing exceptional care to seniors. Join UPMC Senior Communities' esteemed actuarial team and embark on a rewarding career where you can apply your actuarial expertise, make a meaningful impact on the lives of seniors, and enjoy competitive benefits in a supportive and compassionate work environment.