[Remote] REMOTE - Actuarial Analyst II (Medicare) - R8070
Note: The job is a remote job and is open to candidates in USA. CareSource is a healthcare company, and they are seeking an Actuarial Analyst II (Medicare) to provide timely and accurate data analysis. The role involves developing recommendations, conducting profitability reports, and participating in cross-functional teams to improve operational efficiency.
Responsibilities
- Develops actionable recommendations to management relative to all analysis
- Calculates profitability reports on appropriate business segments
- Leads regular and ad-hoc analysis identifying opportunities to improve efficiency and affordability
- Leads regular and ad-hoc analysis/studies to evaluate assumptions used in other processes
- Participates in cross functional teams to address key issues facing the organization
- Prepares monthly calculation of the company's IBNR reserves
- Evaluates government reimbursement process to determine areas of risk and opportunity
- Participates in initiatives to improve operating results
- Initiates key analysis to improve overall MLR results
- Performs other duties as assigned
Skills
- Bachelor's degree in actuarial science, mathematics, economics or a related field is required
- Intermediate database (SAS or Access) experience is required
- A combination of years of industry experience and exams passed under the Society of Actuaries Exam Syllabus (excluding exam SRM via transition credit) equaling 5 or more is required
- Active pursuit of an actuarial designation (ASA) is required
- Intermediate interpersonal/verbal communication skills and a high level of professionalism
- Intermediate written communication skills
- Intermediate ability to work independently and within a team environment
- Intermediate ability to work in fast paced environment with changing priorities
- Intermediate ability to remain calm under pressure
- Intermediate proficiency level with Microsoft Excel
- Intermediate proficiency with Microsoft Suite to include, Word, Power Point and Outlook
- Intermediate ability to effectively present information and respond to questions from peers and management
- Intermediate ability to analyze and interpret financial data in order to coordinate the preparation of financial records
- Intermediate knowledge of SQL, SAS, R, or other data manipulation software
- Effective problem-solving skills with attention to detail
- Effective listening and critical thinking skills
- Experience with Medicare Advantage bids
- Experience with data compilation to support bids
- Experience with desk review audit responses
- Experience developing and using pricing models related to Medicare Advantage
- Experience with Medicare Risk Adjustment
- Experience with building large Excel models
- Proficient with relational databases and coding languages (SQL)
- Experience with DSNP and/or FIDE/HIDE-SNPs
- Minimum of one (1) year of decision support or financial analysis experience is preferred
- Managed Care or healthcare experience is preferred
Benefits
- You may qualify for a bonus tied to company and individual performance
- A substantial and comprehensive total rewards package
Company Overview
Company H1B Sponsorship