UPMC Health Plan's Medicaid/Government Product actuarial team is seeking an Actuarial Analyst III to support the team's Behavioral Health work.
This position applies knowledge of mathematics, probability and statistics 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 Medicaid actuarial team supports PA Medicaid products and this role will focus on support for reserving and reporting for Behavioral Health.
This role can be remote within the continental US.
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Responsibilities:
- May direct or supervise junior actuarial department personnel in the performance of duties.
- Responsible for the development of mathematical models in connection with other departments to predict the impact of proposed changes.
- Preparation of State and Federal filings.
- Presents results of analyses and recommendations to management.
- Documents methods, procedures and results.
- 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.
Qualifications:
- Bachelor's degree in mathematics, statistics, actuarial science, economics or related field and
- 3-5 years of experience in actuarial work in a health insurance, managed care or related consulting business.
- Pursuing S.O.A. certification
- Experience working in a BH-MCO preferred.
- Excellent problem solving and analytical skills. Four actuarial examinations passed or appropriate experience.
- Good oral and written communication skills.
- Strong PC skills.
- Data retrieval skills and relational database experience.
- Works independently.
Licensure, Certifications, and Clearances:
- Act 34
UPMC is an Equal Opportunity Employer/Disability/Veteran
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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.