Duties - duties will vary depending upon unit (Pricing, Medical Cost Analysis, Reserving/Planning)
The Actuarial Analyst II performs semi-routine actuarial and statistical analyses to estimate financial outcomes. Applies knowledge of mathematics, probability, statistics, and principles of business to complete health calculations.
Pricing (Commercial or Medicare):
- Prepares data for pricing research, including experience and trend analyses, book of business studies, CMS revenue and risk score analysis, etc.
- Prepares rating information packages to be delivered to underwriting and other internal customers.
- Prepares rate filings for State Insurance Departments, CMS and other regulatory agencies.
- Prepares and gathers the information necessary for special projects such as demographic factors, competitive analysis and other, as required.
- Performs other duties and special projects as required.
Medical Cost Analysis:
- Prepares analysis and monitors claims trends for each line of business. Segregate's cost, utilization, mix of services, coverage types and effects of benefit and demographic changes.
- Prepares reports of medical cost results, both historical and projected.
- Supports the valuation of medical cost initiatives and tracking of performance against goals.
- Supports the development of trend projections.
- Performs other duties and special projects as required.
Reserving/Planning:
- Develops, calculates and monitors accruals, liabilities and reserves for lines of business assigned. Works with the actuary or management to ensure proper formulae are developed and applied.
- Develops interim estimates of refund liabilities for large accounts and accounts on alternative financial arrangements. May coordinate with Finance and Rating/ Underwriting departments to ensure that ratings methodologies are properly projected and accrued.
- Develops and calculates reserves for new products. Incorporates settlement terms as contained in various filings, agreements with accounts.
- Compiles data to support monthly financial forecasts of premium and claims.
- May assist with preparing the actuarial portions of financial statements and federal income tax returns and compiles, evaluates and certifies statistical data.
- Performs other duties and special projects as required.
- Bachelors degree in Mathematics, Statistics, Economics, Actuarial Services, or related field or equivalent work experience.
- Completion of actuarial course exams P, FM , IFM, LTAM and associated VEE credits, and a minimum of two years of experience is required.
- Solid mathematical background including experience working with risk models, actuarial or mathematical analysis, and using automated or statistical analysis tools, proficiency in Excel required.
- Knowledge of SQL server a plus. Excellent organizational, analytical, and communication skills required.