Ensures that the Actuarial Department provides excellent services to various internal and external clients in the areas of pricing, reserving, forecasting, benefits and product development, provider relations/contracting, underwriting, and compliance. Responsible for supervising actuarial analysts. Responsible for stat and federal filings including actuarial certification. Presents to senior financial leadership team.
Responsibilities:
- Lead the development of monthly valuations.
- Execute valuations timely and ensure optimal quality and consistency of information reported.
- Provide an effective level of visibility into financial results to support analysis, reporting, and business outcomes.
- Own and enhance valuation methodologies and processes.
- Continuously improve valuation models to incorporate the latest data and actuarial and statistical approaches.
- Ensure processes and underlying infrastructure are scalable to support future growth needs.
- Responsible for internal and external facing actuarial reporting and control requirements.
- Assist in the development and filing of Statement of Actuarial Opinions and associated Memoranda.
- Ensure development of robust controls to support financial and regulatory audits and Model Audit Rule
- Forecasting: To provide UPMC HP senior management with regular and ad hoc reports which communicate current and future near- and long-term projections of financial performance of the various health product lines in order to facilitate corporate decision and the development of corporate strategies and goals.
- Benefits and Product Development: To provide appropriate UPMC management personnel with actuarial valuations of the Impact of any proposed benefit changes or new product designs on an as-needed basis.
- Provider Relations/contracting: To provide reports for the purpose of evaluating and advising UPMC HP management on the financial impact of proposed provider agreements or changes to existing agreements on an as-needed basis.
- Additional Business: Ability to learn new lines of business to help UPMC Health Systems to expand into different arenas such as Slop Loss Insurance or Workers Compensation.
- Consultant within UPMC Health System; Act as an Actuarial Consultant within the UPMC Health System and perform various activities, Including IBNR calculations, Data Analysis.
- Assist in building out insurance risk management.
- Work closely with Enterprise Risk Management and key internal stakeholders to build and enhance insurance (underwriting and reserving) risk assessment, monitor changes to the risk profile, risk analytics, and understand key drivers.
- Develop reinsurance analytics and modeling capabilities to foster effective insurance risk and capital decisions.
- Ability to solve issues with a sense of urgency.
Qualifications:
- Associate or Fellow in the Society of Actuaries and 7+ years of relevant actuarial experience and a valuation background within the insurance industry required.
- Must have a comprehensive knowledge of actuarial principles, the Affordable Care Act, Medicare Advantage, and financial and regulatory reporting requirements.
- Demonstrated ability to navigate ambiguity to drive to outcomes, work with large datasets and distill analyses into actionable business insights.
- Collaborative attitude to work in highly cross-functional organizations.
- Experience in SQL or Python is a plus.
Licensure, Certifications, and Clearances:
- Act 34
UPMC is an Equal Opportunity Employer/Disability/Veteran
Working at
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.