Join PacificSource and help our members access quality, affordable care!
PacificSource is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status, such as race, religion, color, national origin, sex, sexual orientation, gender identity or age.
Diversity and Inclusion: PacificSource values the diversity of the people we hire and serve. We are committed to creating a diverse environment and fostering a workplace in which individual differences are appreciated, respected and responded to in ways that fully develop and utilize each person's talents and strengths.
Provide actuarial services in the area of health economics. Work to improve organizational monitoring and management of utilization, unit cost, and service intensity trends. Responsible for accurate and reliable actuarial activities. Provide sound actuarial analysis of risk, resulting in the attainment of PacificSource's financial and enrollment goals. Work to increase enrollment and maintain a strong financial position.
Essential Responsibilities:
- Assist in direction of health economics strategy. Work with VP/Chief Actuary, Actuarial Director of Health Economics, Health Services, Provider Network, Actuarial Pricing and other leadership areas to ensure consistency with partnering departments and alignment with company strategy.
- Develop, implement, and maintain health economics models, coordinating with other departments to ensure compliance with regulatory requirements and consistency with PacificSource policies.
- Assist in development and monitoring of clinical programs and provider contracts.
- Assist in development of organization's cost and utilization trend targets through regular and systematic analysis of experience and forecasting of financial and statistical data in a manner that is actuarially sound, competitive in the marketplace, and provides income in accordance with organization goals and objectives.
- Produce reports for use by management and appropriate departments within PacificSource, such as Provider Network, Health Services, Finance, etc.
- Make documented recommendations based on the analysis of information regarding methods to reduce costs.
- Review requirements for and identify information needed to accurately assess various elements of risk, cost, and utilization, and its financial impact upon PacificSource.
- Actively participate as a key team member in department meetings.
- Actively participate in various strategic and internal committees in order to disseminate information within the organization and represent company philosophy.
Supporting Responsibilities:
- Meet department and company performance and attendance expectations.
- Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
- Perform other duties as assigned.
SUCCESS PROFILE
Work Experience: At least three years actuarial experience required. Health experience, especially in health economics or related areas, preferred.
Education, Certificates, Licenses: Baccalaureate degree in mathematics, statistics, actuarial science, or a related field, or equivalent work experience, required. Required to be enrolled as Associate or Fellow in Society of Actuaries, and active member in good standing of American Academy of Actuaries.
Knowledge: Must possess the knowledge and assume responsibility for performing the functions of the job description. Must perform and be responsible for the functions in a manner which promotes confidence in the person's abilities. Ability to accomplish tasks accurately under pressure, determine priorities, and to meet deadlines. Ability to identify and define problems, design and then implement solutions, and further monitor results, in a continuous cycle. Is creative and innovative in responding to challenges. Ability to apply actuarial methods and modeling techniques. Verifies and documents assumptions, justifies analysis and recommendations with sound logic and actuarial principles, and adheres to Actuarial Standards of Practice.
Competencies
- Adaptability
- Building Customer Loyalty
- Building Strategic Work Relationships
- Building Trust
- Continuous Improvement
- Contributing to Team Success
- Planning and Organizing
- Work Standards
Environment: Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 5% of the time.
Skills:
Our Values
We live and breathe our values. In fact, our culture is driven by these seven core values which guide us in how we do business:
- We are committed to doing the right thing.
- We are one team working toward a common goal.
- We are each responsible for customer service.
- We practice open communication at all levels of the company to foster individual, team and company growth.
- We actively participate in efforts to improve our many communities-internally and externally.
- We actively work to advance social justice, equity, diversity and inclusion in our workplace, the healthcare system and community.
- We encourage creativity, innovation, and the pursuit of excellence.
Physical Requirements: Stoop and bend. Sit and/or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.
Disclaimer: This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.