Job Information
WellSense Senior Actuarial Analyst in United States
Senior Actuarial Analyst
WellSense Health Plan is a nonprofit health insurance company serving members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded 25 years ago as Boston Medical Center HealthNet Plan, we provide plans and services that work for our members, no matter their circumstances.
Apply now (https://jobs.silkroad.com/BMCHP/Careers/Apply/MultiForm/294344)
It’s an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.
The Senior Actuarial Analyst is a key member of the Finance / Actuarial Services team. With minimum guidance and supervision, the Senior Actuarial Analyst applies knowledge of mathematics, probability, statistics, and principles of business in order to provide assistance and technical support for more extensive rating/pricing, reserving, medical economics, financial forecasting, and/or healthcare data analytics. The Senior Actuarial Analyst works with a team of actuaries to assure a coordinated approach to the actuarial components of health programs, and provides actuarial support to Finance, and/or other departments in the company.
Our Investment in You:
Full-time remote work
Competitive salaries
Excellent benefits
Key Functions/Responsibilities:
Analyzes financial, statistical and mathematical data and performs actuarial calculations
Leads or supports the rate development through analyses of benefit design, rating factors, claims experience, regulatory mandates, admin expense allocation, and projection of future claim cost
Leads or supports regulatory rate filings, and prepares data for additional inquiries and requirements
Leads or supports the development of monthly IBNR reserve estimates for different line of business
Prepares monthly accruals and contract settlements for different line of business
Leads or supports financial budget, reforecast and other financial projections
Evaluates and makes recommendations regarding the adequacy of capitation rates from state Medicaid programs or other new program
Leads or assists in risk adjustment analyses and risk score simulations
Leads or supports trend development, trend drivers study, and/or provider contract analytics
Maintains established reports for internal needs or regulatory requirements
Participates in internal and external audits
Participates in requirements gathering for and serves as delegate or backup for corporate initiatives/projects
Generates ideas and analytical approaches for corporate initiatives/projects
Designs or updates SQL/SAS queries and programs to extract data from data warehouse, and reviews the data to ensure accuracy and validity
Serves as data expert for department
Advises Finance department on data warehouse design, requests and works with IT to establish priorities
Initiates and leads efforts to improve quality and efficiency of actuarial models, analyses and reports
Summarizes findings and recommendations, documents the process
Develops presentations and communicates to senior management or external parties
Shares knowledge and provides training to new employees
Qualifications:
Education:
- Bachelor’s Degree in Mathematics, Actuarial Science, Finance, Economics or related fields
Experience:
At least 4 years of progressively responsible experience in actuarial analysis, data modeling, informatics and analysis
Commensurate educational experience in related field will be considered
Preferred/Desirable:
A background in managed healthcare, insurance operations
Master’s degree
ASA or FSA
Competencies, Skills, and Attributes :
Should be experienced in MS Office products, SQL, and SAS or other statistical software
Should be proficient in Excel
Should be an experienced user of healthcare data
Ability to meet deadlines, multi-task, problem solve and use appropriate technology to analyze business problems
Ability to work collaboratively with team members and other departments
Strong communications skills
About WellSense
WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances.WellSense is committed to the diversity and inclusion of staff and their members.
Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees
Apply now (https://jobs.silkroad.com/BMCHP/Careers/Apply/MultiForm/294344)
Important info on employment offer scams:
According to the FTC, there has been a rise in employment offer scams. Our current job openings are listed on our website and applications are received only through our website. We do not reach out to individuals via text, we do not ask or require downloads of any applications, or “apps”, and applicant screenings, interviews and job offers are not conducted over text messages or social media platforms. We do not ask individuals to purchase equipment for, or prior to employment. To avoid becoming a victim of an employment offer scam, please followthese tips from the FTC (https://consumer.ftc.gov/consumer-alerts/2023/01/looking-job-scammers-might-be-looking-you?utm_source=govdelivery) .