UPMC Senior Communities

UPMC is an Equal Opportunity Employer/Disability/Veteran

Actuary - Medical Cost Initiatives

Location

United States

Posted

58 days ago

Salary

$47 - $82 / hour

Seniority

Mid Level

No structured requirement data.

Job Description

Actuary - Medical Cost Initiatives

UPMC Senior Communities

Role Description Shape the world of health care by joining UPMC! As a leader in the industry, we are committed to enhancing the lives of all who are a part of our community. Without our employees, we would not be able to innovate health care for our patients and health plan members. To continue our tradition of excellence, we are in search of a full-time Actuary to join this community. UPMC Health Plan is seeking an Actuary in its Department of Health Economics. This credentialed healthcare actuary would drive high-visibility impactful analysis and would be responsible for developing and driving medical cost improvement strategies. Responsibilities include: - Lead the development of detailed actuarial and financial models to communicate near and long-term projections of financial performance of new and ongoing initiatives and clinical programs. - Analyze impacts of healthcare affordability initiatives on medical cost and utilization trends. - Apply analytical and statistical software tools to summarize large healthcare data to glean findings and actionable insights. - Incorporate healthcare claims cost and utilization trends into the development of projections used to define savings methodologies for affordability initiatives and programs. - Develop and gain support for data-based recommendations with team members from product, clinical, network, and strategy functions. - Guide the development of well-documented standard actuarial reports and projects. - Present results of analyses and recommendations to management and senior leaders. - Apply an understanding of complex actuarial concepts, methods, and applications in a variety of situations. - Creatively leverage a wide range of datasets to inform key analyses. - Provide direction and supervision to less experienced staff in the performance of duties. - Build strong relationships within cross-functional workgroups including Clinical, Pharmacy, Network, Actuarial, Analytics, and Finance teams across the enterprise. - Ensure that departmental work products meet the highest standards of quality. - Provide analytical support for ad hoc data analyses. Qualifications - Bachelor's degree in mathematics, statistics, actuarial science, economics or related field. - ASA or FSA certification. - 5+ years of experience in actuarial work in a health insurance, managed care or related consulting business; or equivalent training, education and/or experience. - Experience in evaluation of medical cost and utilization savings initiatives; statistical techniques for the evaluation of clinical programs; trend analysis; population health; utilization management (UM) / care management (CM) / disease management (DM) analysis is a strong preference. - Experience with commercial and government health programs is preferred. - In-depth understanding of health insurance market dynamics. - Excellent problem-solving and analytical skills. - Excellent oral and written communication skills. - Adaptability and ability to prioritize effectively. - Strong PC skills. - Data retrieval skills and relational database experience are required, including SQL and/or SAS. - Data visualization experience is preferred. Requirements - A.S.A. or F.S.A. certification by Society of Actuaries. - Membership in the American Academy of Actuaries. Benefits - Support for professional designations through our comprehensive student program. - Continuing education opportunities. Company Description UPMC is an Equal Opportunity Employer/Disability/Veteran.

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