Senior Actuarial Analyst

Position Summary:

The Senior Actuarial Analyst position will report to the Vice President of Actuarial Services and provide support in several different areas including reserves, risk adjustment, Part D and bid review. This would be a great opportunity for someone looking to deepen their actuarial knowledge while also expanding their operational knowledge.

General Duties/Responsibilities (May include but are not limited to):

·         Understand and perform traditional actuarial methods to determine monthly reserve balances, RAF accruals and Part D pass through accruals

·         Conduct audits of these approaches and recommend changes due to changing circumstance and operational deviations

·         Work closely with HealthPlan Economics team and Medicare Risk Adjustment teams to review financial performance of markets and identify key opportunities and risks

·         Monitor KPIs related to claim adjudication and utilization management

·         Can explain purpose and function of actuarial methods and analyses to areas outside of the department

·         Conduct and develop data driven analysis to support strategic decision making

·         Assess risk and opportunities of these analyses

·         Other duties as assigned

Supervisory Requirements:

Not applicable

Minimum Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1.       Minimum Experience:

a.       3 years minimum of required work experience here

2.       Education/Licensure:

a.       Requires college degree with at least a minor in mathematics, statistics, computer science or equivalent business experience

3.       Other:

a.       Previous knowledge of Medicare Advantage is preferred

b.       ASA designation or has completed the majority of the courses to complete the ASA designation

c.       Programming experience in SQL, R or Python is a plus

d.       Curious mindset and eagerness to learn within the actuarial field and also outside the traditional actuarial field

4.       Work Environment:

1. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.