May 25, 2024

Sr. Actuarial Analyst - Seniors Products Forecasting

  • Professional Diversity Network
  • Portland, ME, USA
Full-Time Nurse

Job Description

Point32Health, Inc.

Who We Are

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. To learn more about who we are at Point32Health, click here.

Job Summary

The Sr Actuarial Analyst independently conducts analysis and data development, and guides the work of junior staff, for a broad range of financial and actuarial functions including financial planning and forecasting, trend analysis, product development, provider reimbursement analysis, fee schedule development, provider risk analysis, and medical cost containment analysis. This is a senior analytical and technical position and as such must be able to perform independently and execute and/or oversee all the analytical and technical tasks required to take a project from inception to conclusion. This role will work closely with one or more departments including underwriting, sales, contracting, finance, and clinical services.

A thorough understanding of the health insurance industry with proficiency in relational databases, data warehouses, Excel, and statistical modeling, as well as strong interpersonal skills, are required.

The position is eligible to participate in the Actuarial Student Program, including job rotations every 18-36 months and comprehensive support of the pursuit of Fellowship in the Society of Actuaries.

Key Responsibilities/Duties - what you will be doing

  • Performs analytic project work assigned by manager with minimal supervision
  • Develops analytic project plan to meet defined objectives
  • Facilitates planning and review sessions
  • Collaborates with manager in defining project objectives, and design components of larger projects
  • May manage one or more large projects
  • Uses Healthplan data systems and query tools to complete work projects, developing new code and tools to meet objectives
  • Designs and builds technical processes to address business issues
  • Provides input into and/or help structure program code for more junior staff
  • Develops criteria to validate results in light of prior expectations
  • Investigate unusual results and offers explanations
  • Examines and interprets results in the context of the specific business questions being addressed
  • Identifies new questions and/or unforeseen data complexities arising from results and takes steps to address them
  • Integrates information from multiple sources to interpret results in larger business context
  • Other projects and duties as assigned.

Qualifications - what you need to perform the job

Education, Certification and Licensure

  • College degree in related field or equivalent education/training
  • Actuarial exam progress
  • ASA or FSA designation preferred

Experience (minimum years required):

  • 5+ years of responsible healthcare actuarial/analytic experience
  • Management: Experience mentoring or training others
  • Analytic: Demonstrated experience in analytic project design
  • Technical: Proficiency in the use of personal computers, relational databases, statistical packages, spreadsheet and/or database applications

Skill Requirements

  • Ability to design and build complex technical applications
  • Communication/Presentation skills
  • Well-developed verbal and written skills
  • Ability to facilitate planning and review sessions;
  • Solid presentation skills; presents to senior level department management
  • Negotiation/Leadership skills
  • Able to operate in a matrix environment
  • Able to implement Actuarial department standards and processes
  • Able to identify issues and roadblocks and participate in their resolution
  • Independence/Judgment
    • Receives regular management oversight of selected projects and processes
    • Applies own judgment on most analytical and technical issues with input on organization and implementation
  • Interpersonal skills (include personal interaction):
    • Must be able to work cooperatively as a team member.
    • Regular interface with various levels of leadership, staff and providers is required as well.

Working Conditions and Additional Requirements (include special requirements, e.g., lifting, travel):

  • Must be able to work under normal office conditions and work from home as required.
  • Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
  • May be required to work additional hours beyond standard work schedule.

Compensation & Total Rewards Overview

As part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Company's sole discretion and may be modified at the Company's sole discretion, consistent with the law.

Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes:

  • Medical, dental and vision coverage

  • Retirement plans

  • Paid time off

  • Employer-paid life and disability insurance with additional buy-up coverage options

  • Tuition program

  • Well-being benefits

  • Full suite of benefits to support career development, individual & family health, and financial health

For more details on our total rewards programs, visit https://www.point32health.org/careers/benefits/

Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity

Point32Health is committed to making diversity, equity, inclusion, accessibility and health equity part of everything we do-from product design to the workforce driving that innovation. Our Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity team's strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

PDN-9c1dce4f-cf49-4535-813c-d29fd5352ad0

Apply Now