The Financial Analysis Department is responsible for the development of various financial models used to forecast medical cost trends, provide support for provider contract negotiations, assess actuarial rate development studies, participate in annual budgeting functions.
Seeking a highly motivated an experienced Actuary to join our team. The Actuary will ensure the fiscal integrity of client's program and policy decisions and facilitate executive decision making by providing timely and accurate actuarial and financial analyses. The incumbent will be responsible for the ongoing financial planning and analysis needs of the organization, including the review and analysis of revenue, medical costs and their underlying trends.
Responsibilities:
80% - Financial Analysis Support
Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
Develops clinical utilization, cost profiles and other indicators for all areas of medical costs, including but not limited to Direct, pharmacy and skilled nursing facilities.
Completes analysis to support regulatory filings, including state rate development models and Medicare Advantage bids.
Supports operating budget development and monthly reporting analysis.
Responsible for incurred but not reported reserves (IBNR) modeling and analysis.
Advises management of significant changes or unusual trends in medical costs and proposes recommendations for management consideration.
Supports activities related to regulatory and financial audits and findings.
Assists with the development of appropriate reimbursement rates and other financial contract provisions with the state of California.
Assists in evaluation of decision support and analysis tools, as well as improvements to the data warehouse.
Supports management with budgeting and forecasting duties.
15% - Administrative Support
Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
Provides direction and guidance to Financial Analysis staff in accordance with established departmental and organizational policies.
Serves as primary liaison with external actuarial services and support.
5% - Completes other projects and duties as assigned.
Experience:
3 years of health care informatics or actuarial experience required.
Skills:
Include pointers related to the tools and skill sets expected.
Education:
Bachelor's degree in health care economics/planning, business, mathematics or related field required.
Associate of the Society of Actuaries (ASA) certification required.
About US Tech Solutions:
US Tech Solutions is a global staff augmentation firm providing a wide range of talent on-demand and total workforce solutions. To know more about US Tech Solutions, please visit www.ustechsolutions.com.
US Tech Solutions is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.