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| |  Posted 4/13/2005 9:38:17 AM | |
| Supreme Being
Group: Administrators
Last Login: 1/29/2007 9:04:03 AM
Posts: 4,199, Visits: 95 |
| Position: Senior Actuarial Associate & Manager, Claim Trend/Modeling
Company:Insurance Organization
Location: Massachusetts
Job ID: 3315
Responsibilities:
·Develops claim trends for use in pricing all group products and develops models for use in setting corporate pricing strategies. This will include being responsible for working with staff in finance, provider contracting, medical management and other areas, plus analysis of HPHC’s claims experience, to develop trend recommendations that will be used by the Actuarial Pricing Team in the development of rates for all group products.
·Is responsible, working with the Director and the Actuarial Pricing team, for the development of strategic models e.g./ to illustrate and develop the rate and retention charge strategies for all HPHC’s products and markets.
·The incumbent will serve as the Actuarial representative on various committees, including Trend Team, Trends on Demand, etc. ESSENTIAL FUNCTIONS: 1. Collaborates closely with Director to design the models to develop recommended pricing strategy throughout the organization. 2. Develops recommended claim trends (except pharmacy) for pricing all group products. 3. Responsible for identifying and developing claim trend analyses and monitoring tools. 4. Builds relationship with areas throughout the organization including Financial Planning & Analysis, Provider Contracting and Medical Management. 5. Develops factors for use in pricing new benefits or products and in the development of the rate impact of changing benefits. 6. Is the subject matter expert for Actuarial Pricing relative to data quality and access to data. 7. Responsible for creating efficiencies within the Actuarial Department through process or system innovation. 8. Responsible for the development, motivation, assessment and reward of employees. Position applies broad management expertise in planning, integrating and leading staff in the implementation of programs or initialization is strategic to nature. Responsible for day-to-day staff management in the Actuarial Claim Trend/Modeling Team. Reports to: Director, Actuarial Pricing Staff: Two (2) Actuarial Associates and One (1) Analyst. Will re-evaluate staffing requirements throughout 2005 related to claim trend responsibilities. Frequent Contacts: Director, Actuarial Pricing; Director, Employer Reporting; Actuarial Managers; Director, Underwriting; Underwriting Managers; Chief Actuary; CFO; SVP, Sales; Sales Directors; Directors, IT; Team Leaders and Staff; Staff in Provider ontracting; Directors of Business Finance and Strategic Planning; Director of Actuarial Systems and Reporting
Qualifications:
·Strong financial and actuarial background with extensive knowledge of the HMO industry including experience evaluating claim cost trends through a solid understanding of the impact on claim costs, of provider contracts, provider risk sharing and medical management strategies
·7 years professional actuarial experience, including at least 2 years in a supervisory position.
·Associate or Fellow in the Society of Actuaries.
·A minimum of 3 years of experience analyzing health care data for the purpose of recommending trends for pricing HMO and other medical products.
·Must have knowledge of computer systems in general, and expertise in the use of spreadsheets and databases.
·Excellent written, verbal and presentation skills with ability to negotiate effectively are essential.
·Proven abilities to manage highly complex projects within and across departmental lines.
·Solid understanding and appreciation of the inter-related processes within a managed care organization.
·The abilities to work in a team environment, to foster a team environment with direct reports, and to manage and develop staff performance is essential.
Online Application available at www.jobs4actuary.com
For further information, email info@nasearchg.com and mention Position #3315, or contact any of our recruiters at (905)-477-2962. |
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