Senior Actuarial Manager

Baystate Health

Springfield, MA

JOB DETAILS
SALARY
$158,371–$182,041 Per Year
LOCATION
Springfield, MA
POSTED
30+ days ago
Summary:


Schedule: 8am-5pm Monday-Friday


Location: 1 Monarch Place; Springfield MA; Hybrid Opportunity


This position will perform actuarial analyses for Commercial, Medicaid and Medicare business including, but not limited to: medical expense analyses and projections, determining rates and preparing supporting documentation for rate filings with DOI, pharmacy analytics and projections, building and maintaining rate models, analyzing data in support of monthly reserve process, and ad hoc actuarial analyses. In addition this position will work closely with the legal department to identify, size and communicate financial risks and opportunities related to legislative and regulatory changes including impacts to premiums, benefits and product designs.


Accountabilities


+ Provide data and support for the development of rate filings for submissionto the Department of Insuranceand CMS.


+ Closelymonitorsand assesses competitors' rates,trendsand rating methodologies.


+ Supports various initiatives as needed by actuarial modeling.


+ Develops/enhances ad hoc reports toassistin actuarial analyses of emerging results.


+ Creates andmaintainslarge databases of informationutilizinga unique skill set ofspreadsheetand relational database abilities.


+ Assistsin setting and documenting financial liabilities including IBNR Reserves, PDR, RiskAdjustmentand other outstanding items.


+ Conducts cross-functional analysis of health care data toidentifytrends and risks.


+ Develop data and reports in support of reinsurance, riskadjustmentand risk corridors, ensuringaccurateimpactsinpricing and coordination withrebate determination.


+ Assess the financial or pricing impact of variations in benefits and provider contracts.


+ Estimate mandated benefit cost and calculate pricing ofbenefit changes.


+ Tracks trends andreportspertinent financial andutilizationinformation.


+ Perform other related projects and duties as assigned.


Internal


+ Finance


+ Analytics and Reporting


External


Organization’s name


+ NCQA


_Dimensions_


Examples:


+ Business unitssupported


+ Financial dimensions (e.g.,capitalbudget,annualprojectcost,operating budget)


+ Regulatory bodies andspecial requirements


+ NCQA Accreditation standards


+ HNE Policies and Procedures supporting NCQA standards


+ Gap analysis


+ SupportsHNE LOBsto meet NCQA accreditation standards


Education / Experience / Other Information(include only those that are specific to the role)


+ Bachelor's Degreerequired, preferably in Actuarial Science/Mathematics/Finance/Healthcare Management or a related field or an equivalent combination of education and experience.


+ 3-4 Actuarial Exams minimum, ASA preferred


+ 2-3years ofpreviousexperience.


+ Excellent quantitative, problemsolvingand analytical skills.


+ Strong communicationskills.


+ Technical skills with database concepts, data analysis development, datawarehousingand decision support tools.


+ Knowledge of MS-Office products,SASor SQLrequired.


Working Conditions


Standard office-based environment; non-standard hours may be of occurrence. Limited travel required, usually pre-planned. Extensive period working with laptops and looking at monitors may cause visual discomfort.


Education:


Bachelors Degree (Required)


Certifications:


Compensation


Note: The compensation range(s) in the table below represent the base salaries for all positions at a given grade across the health system. Typically, a new hire can expect a starting salary somewhere in the lower part of the range. Actual salaries may vary by position and will be determined based on the candidate's relevant experience. No employee will be paid below the minimum of the range. Pay ranges are listed as hourly for non-exempt employees and based on assumed full time commitment for exempt employees.


Minimum - Midpoint - Maximum


$158,371.00 - $182,041.00 - $215,342.00


Equal Employment Opportunity Employer


Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.

About the Company

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Baystate Health