What are the responsibilities and job description for the Actuary - Denver Health Medical Plan (Must Be A Resident of Colorado) position at Denver Health?
We are recruiting for a motivated Actuary - Denver Health Medical Plan (Must Be A Resident of Colorado) to join our team!
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Being the heartbeat of Denver means our heart reflects something bigger than ourselves, something that connects us all :
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Department
Managed Care Administration
Denver Health Medical Plan is not your ordinary health insurance carrier. Unlike regular insurance companies that operate to make a profit for their shareholders, we're a local, nonprofit company that directs our funds toward the well-being of our members and making quality care accessible to all.
Since 1997, we've dedicated ourselves to serving the Denver metro community. Today, more than 100,000 members trust us with their health care needs.
Job Summary
Assist the activity of the organization's actuarial and medical economics work. Work with external teams of actuaries and analysts to complete rate filings, analysis of the local healthcare landscape, help increase risk adjustment capture and aid product teams in benefit design analysis. Helps with coaching, training, and support to educate other departments when necessary. Works with the analytics team to ensure data accuracy for rate filings and has a firm understanding of healthcare data complexity. Keeps track of the regulatory environment across multiple product lines in conjunction with the product teams to ensure that elements that might affect pricing, network strategy, and risk adjustment are considered when filing rates. Works collaboratively with the other departments to achieve alignment between rate setting and risk adjustment initiatives. Suggests strategic initiatives to lower healthcare costs, maintain quality and generate risk adjustment opportunities.
Essential Functions :
- Lead the development of product pricing and reserves for various health insurance products. (20%)
- Conduct analysis and make recommendations on rate changes, product design, and medical management policies based on data-driven insights (20%)
- Review and analyze trends in healthcare utilization, cost, and quality to identify opportunities for cost containment through contracting or care management activities. (20%)
- Manage the budget and resources of the actuarial and medical economics teams to ensure efficient and effective operation. (20%)
- Collaborate with numerous departments to develop company-wide policies and procedures related to actuarial, medical economics and risk adjustment functions. (20%)
Education :
Work Experience :
Licenses :
Knowledge, Skills and Abilities :
Shift
Days (United States of America)
Work Type
Regular
Salary
129,635.00 - $200,376.00 / yr
Benefits
Outstanding benefits including up to 27 paid days off per year, immediate retirement plan employer contribution up to 9.5%, and generous medical plans
Free RTD EcoPass (public transportation)
On-site employee fitness center and wellness classes
Childcare discount programs & exclusive perks on large brands, travel, and more
Tuition reimbursement & assistance
Education & development opportunities including career pathways and coaching
Professional clinical advancement program & shared governance
Public Service Loan Forgiveness (PSLF) eligible employer free student loan coaching and assistance navigating the PSLF program
National Health Service Corps (NHCS) and Colorado Health Service Corps (CHSC) eligible employer
Our Values
Respect
Belonging
Accountability
Transparency
All job applicants for safety-sensitive positions must pass a pre-employment drug test, once a conditional offer of employment has been made.
Denver Health is an integrated, high-quality academic health care system considered a model for the nation that includes a Level I Trauma Center, a 555-bed acute care medical center, Denver's 911 emergency medical response system, 10 family health centers, 19 school-based health centers, Rocky Mountain Poison & Drug Safety, a Public Health Institute, an HMO and The Denver Health Foundation.
As Colorado's primary, and essential, safety-net institution, Denver Health is a mission-driven organization that has provided billions in uncompensated care for the uninsured. Denver Health is viewed as an Anchor Institution for the community, focusing on hiring and purchasing locally as applicable, serving as a pillar for community needs, and caring for more than 185,000 individuals and 67,000 children a year.
Located near downtown Denver, Denver Health is just minutes away from many of the cultural and recreational activities Denver has to offer.
We strongly support diversity in the workforce and Denver Health is an equal opportunity employer (EOE).
Denver Health values the unique ideas, talents and contributions reflective of the needs of our community. For more about our commitment to diversity visit : https : / / www.denverhealth.org / for-professionals / careers / diversity-and-inclusion
Applicants will be considered until the position is filled.
Salary : $129,635 - $200,376
