Actuarial Analyst III

Job Description Summary

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CareMore Health is a proud member of the Mosaic Health family of brands, offering clinical programs and primary care options for seniors. We are a team of committed clinicians and business leaders passionate about transforming American healthcare delivery.
This is a remote, individual contributor role. The Actuarial Analyst III completes very diverse and complicated projects and performs very complex actuarial studies.

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How will you make an impact & Requirements

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Actuarial Analyst III

Work schedule: Monday - Friday, 8:00 am to 5:00 pm EST or CST

Primary duties may include, but are not limited to:

• Analyzes and implements risk contracts including conducting experience analyses, pricing, filing and settlement work; and prepares management reports supporting new capitation initiatives.
• Assists in training of actuarial trainees, analysts and specialists.
• Coordinates/directs special actuarial projects.
• Collaborates with the data warehouse analysts in establishing business rules and monitoring adherence.
• Support data extraction, analysis and transformation to produce final
• Provides business expertise regarding the appropriate use of data elements and cooperates with reporting personnel from other areas to establish and maintain these common business rules.
• Translates data trends into strategic recommendations for program development and action plans.
• Tracks and prioritizes projects through coordination and negotiation with internal and external clients to improve the efficiency of information/project plan generation.
• Evaluates and triages potential projects and studies based on the value, cost benefit analysis and the urgency of the request.
• Performs strategic data analysis (data mining) and research as appropriate to support business needs (e.g., disease management, provider profiling, etc.).
• Develops detailed understanding of relevant business processes, goals and strategy in order to provide analysis and interpretation.
• Develops and communicates action plans to address areas for improvement identified through data analysis and business expertise.
• Assists in planning initiatives to address areas for improvement.
• Collaborates with business user to define media, frequency and audience for distribution of information.
• Mentors (formally and informally) less experienced associates and identifies training needs and initiates education to address skill and knowledge gaps.

Minimum Requirements:

• Requires a BA/BS and to have passed a minimum of four Society of Actuaries (SOA) actuarial exams and a minimum of 3 year related experience; or any combination of education and experience, which would provide an equivalent background.

Preferred Skills, Capabilities, and Experiences:

• Excellent knowledge and understanding of data warehouse data structures and data flows is strongly preferred.
• Excellent oral and written communication, analytical and planning skills and knowledge of standard Business Information tools and programming/query languages preferred. 
• Experience in managed care and data analysis is preferred. 
• Practical business experience is preferred.
• Background in Medicare or other public health insurance programs with understanding of risk adjustment programs
• Actively working towards ASA/ FSA.
• SAS, SQL, and other programming language experience preferred.
• Tableau dashboarding experience preferred
• 4-6 years of experience in an actuarial department, Medicare Advantage risk adjustment experience preferred.
• Work closely with other teams to monitor performance against forecasts, analyzing and explaining drivers of variances from revenue, RAF and membership
• Proficiency with Microsoft office tools with preferred emphasis on Excel.

Compensation:  $90,640K - $135,960K/annual salary & bonus eligible

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