What are the responsibilities and job description for the Actuary Lead- Value Based Contracting (Remote, US) position at UPMC?
UPMC Health Plan has an exciting opportunity for an Actuary Lead on their rockstar Value-Based Contracting Team!
This position applies knowledge of mathematics, probability, and statistics in order to identify issues and gather and analyze data on a wide variety of topics affecting the financial performance of the health plan. Ensure timely and accurate services to clients. Supports strong internal and external relationships.
Preferences:
- Working experience in SQL and Excel
- Experience following fields: value-based contracting, pricing, reserving, trend/health economics, provider network analysis, risk adjustment, etc
- FSA or ASA
This role can be remote anywhere within the US!
Responsibilities:
- Presents results of analyses and recommendations to actuarial management.
- Develop junior actuarial department staff
- Support the Medicare Bid process, including preparing presentations, providing all requested reports and pricing, responding to desk review queries, and working with other departments to file all bids in a timely manner
- Responsible for the preparation of financial analyses in support of the following functions: Medical cost and utilization trend analysis; Forecasting; - Provide analytical support for rate development and filings; - Provide ad hoc data analysis to all departments within the company.
- Documents methods, procedures and results.
- Provide actuarial support and requests for the annual CMS Financial Audits; communicate with auditors when needed
- Will direct junior actuarial department personnel in the performance of duties.
- Price, analyze, and assign annual premium increases/decreases to Medicare Employer Groups; includes communication with product development/ sales and the ability to explain pricing decisions to senior management
- Review of other's work product.
- Prepares and reviews Medicare Bid Submissions.
- Responsible for the development of mathematical models in connection with other departments to predict the impact of proposed changes.
- Will own project management of projects, including deliverables and appropriate work.
Salary : $50 - $85
