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Actuarial Analyst II at Independence Blue Cross LLC in Philadelphia, Pennsylvania

Posted in Admin - Clerical 30+ days ago.

Type: Full-Time





Job Description:

Bring your drive for excellence,
team orientation and customer commitment to Independence; help us renew and
reimagine our business and shape the future of health care.  Our
organization is looking to diversify, grow, innovate and serve, and we are
looking for committed, empowered learning-oriented people to join our team.
 If this describes you, we want to speak with you.


Description:
 
Duties – duties will vary depending on unit (Pricing, Medical Cost Analysis, Reserving/Planning)


The Actuarial Analyst II performs semi routine actuarial and statistical analyses to estimate financial outcomes.  Applies knowledge of mathematics, probability, statistics, and principles of business to complete health calculations. 


Pricing (Commercial or Medicare)


  • Prepares
    data for pricing research, including experience and trend analyses, book of
    business studies, CMS revenue and risk score analysis, etc.

  • Prepares
    rating information packages to be delivered to underwriting and other internal
    customers.

  • Prepares
    rate filings for State Insurance Departments, CMS and other regulatory
    agencies.

  • Prepares
    and gathers the information necessary for special projects such as demographic
    factors, competitive analysis and other, as required.

  • Performs
    other duties and special projects as required.

Medical Cost Analysis

  • Prepares
    analysis and monitors claims trends for each line of business.  Segregates cost, utilization, mix of
    services, coverage types and effects of benefit and demographic changes.

  • Prepares
    reports of medical cost results, both historical and projected. 

  • Supports
    the valuation of medical cost initiatives and tracking of performance against
    goals.

  • Supports
    the development of trend projections.

  • Performs
    other duties and special projects as required.

Reserving/Planning

  • Develops,
    calculates and monitors accruals, liabilities and reserves for lines of business
    assigned.  Works with the actuary or
    management to ensure proper formulae are developed and applied. 

  • Develops
    interim estimates of refund liabilities for large accounts and accounts on
    alternative financial arrangements.  May
    coordinate with Finance and Rating/ Underwriting departments to ensure that
    ratings methodologies are properly projected and accrued.

  • Develops
    and calculates reserves for new products. 
    Incorporates settlement terms as contained in various filings,
    agreements with accounts. 

  • Compiles
    data to support monthly financial forecasts of premium and claims. 

  • May
    assist with preparing the actuarial portions of financial statements and
    federal income tax returns and compiles, evaluates and certifies statistical
    data.

  • Performs
    other duties and special projects as required.

Qualifications


  • Bachelors
    degree in Mathematics, Statistics, Economics, Actuarial Services, or
    related field or equivalent work experience. 

  • Completion of
    actuarial course exams P, FM , IFM, LTAM and associated VEE credits, and a
    minimum of two years of experience is required. 

  • Solid
    mathematical background including experience working with risk models,
    actuarial or mathematical analysis, and using automated or statistical
    analysis tools,

  • Proficiency in
    Excel required. 

  • Knowledge of
    SQL server a plus.

  • Excellent
    organizational, analytical, and communication skills required.