Senior Actuarial Analyst - Provider Network & Clinical

Emblem Health New York , NY 10007

Posted 5 days ago

Provides actuarial services in support of the Provider Network Management and Clinical areas. With specific responsibilities of providing data, analytics and reporting in support of provider contracting and value-based reimbursement arrangements, providing data and analytics in support of vendor management and relationships, analyzing trends and interpreting results for matrix partners, supporting contract negotiations and interpreting results/impacts using data, identifying root causes and opportunities for medical and pharmacy cost savings.

Responsibilities:

  • Support ongoing financial analysis and reporting on various provider contracts and Value Based reimbursement arrangements, e.g. ACO Shared Risk/Shared Savings arrangements

  • Provide data and analysis in support of third-party delegate management, from the RFP phase through post-implementation performance tracking and financial oversight (e.g. with ancillary risk vendors, global risk entities)

  • Provide data and analytics in evaluating / validating total medical and pharmacy cost savings in support of the Health Care Cost Containment Initiatives (HCCI) process.

  • Analyze, understand, and explain trend variances. Identify opportunities/initiatives to reduce medical costs.

  • Provide other actuarial analysis as required to Provider Contracting area.

  • Regular attendance is an essential function of the job. Performs other duties as assigned or required.

Qualifications:

  • Bachelor's degree in Economics, Mathematics, or similar major required; advanced degrees a plus

  • Minimum of 2 Society of Actuaries exams passed

  • Proficient in Excel required; SAS preferred

  • 1-2 years health insurance actuarial experience, preferably in the managed health care industry required

  • Intermediate understanding of actuarial principles and methodologies along with good mathematical and analytical skills required

  • Highly proficient in the application of spreadsheet and database management software required

  • Familiar with medical trend analyses required

  • Excellent communicator required

  • Demonstrated ability to learn and adapt required

  • Demonstrated team player required

Additional Information

  • Requisition ID: 2102K
icon no score

See how you match
to the job

Find your dream job anywhere
with the LiveCareer app.
Mobile App Icon
Download the
LiveCareer app and find
your dream job anywhere
App Store Icon Google Play Icon
lc_ad

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Senior Actuarial Analyst Provider Network Clinical Management

Advantagecare Physicians

Posted 2 months ago

VIEW JOBS 1/23/2021 12:00:00 AM 2021-04-23T00:00 Provides actuarial services in support of the Provider Network Management and Clinical areas. With specific responsibilities of providing data, analytics and reporting in support of provider contracting and value-based reimbursement arrangements, providing data and analytics in support of vendor management and relationships, analyzing trends and interpreting results for matrix partners, supporting contract negotiations and interpreting results/impacts using data, identifying root causes and opportunities for medical and pharmacy cost savings. Responsibilities: * Support ongoing financial analysis and reporting on various provider contracts and Value Based reimbursement arrangements, e.g. ACO Shared Risk/Shared Savings arrangements * Provide data and analysis in support of third-party delegate management, from the RFP phase through post-implementation performance tracking and financial oversight (e.g. with ancillary risk vendors, global risk entities) * Provide data and analytics in evaluating / validating total medical and pharmacy cost savings in support of the Health Care Cost Containment Initiatives (HCCI) process. * Analyze, understand, and explain trend variances. Identify opportunities/initiatives to reduce medical costs. * Provide other actuarial analysis as required to Provider Contracting area. * Regular attendance is an essential function of the job. Performs other duties as assigned or required. Qualifications: * Bachelor's degree in Economics, Mathematics, or similar major required; advanced degrees a plus * Minimum of 2 Society of Actuaries exams passed * Proficient in Excel required; SAS preferred * 1-2 years health insurance actuarial experience, preferably in the managed health care industry required * Intermediate understanding of actuarial principles and methodologies along with good mathematical and analytical skills required * Highly proficient in the application of spreadsheet and database management software required * Familiar with medical trend analyses required * Excellent communicator required * Demonstrated ability to learn and adapt required * Demonstrated team player required Additional Information * Requisition ID: 2102K Advantagecare Physicians New York NY

Senior Actuarial Analyst - Provider Network & Clinical

Emblem Health