Actuary, Senior

Actuary, Senior---------------------------------------------------------------This senior level position is responsible for performing a wide variety of financial and actuarial analyses impacting strategic decision making and the company’s financial sustainability efforts. Areas of analysis include cost and utilization trend analysis, return on investment evaluations, Medicare bid development, rate setting optimization, forecasting support, benchmarking, risk adjustment optimization, provider payment evaluation and review of actuarial estimates such as IBNR and PDR. This position provides financial stewardship by identifying opportunities for improved financial performance.Estimated Hiring Range:$138,150.00 - $168,850.00Bonus Target:Bonus - SIP Target, 5% AnnualCurrent CareOregon Employees: Please use the internal Workday site to submit an application for this job.---------------------------------------------------------------Essential ResponsibilitiesFinancial and Actuarial AnalysesDrill down into cost and utilization trends to identify key drivers.Develop profitability analytics to support evaluation by provider group, contract, and other valued indicators.Design, develop, and implement evaluation tools in measuring the effectiveness of programs and payment models.Develop cost savings calculators for use in goal setting, budgeting, and forecasting.Provide rate setting support through data analysis, policy review and strategy development.Identify any actuarial unsound adjustments to the rates.Provide medical cost and utilization trend recommendations for forecasting purposes.Gather and develop benchmarks for purposes of assessing our performance and the potential for improvement.Monitor risk adjustment applied to capitation revenue and ensure population risk is appropriately represented in encounter data.Evaluate provider payment models, including risk share arrangements, to ensure they achieve the desired outcome.Prepare regular risk share reporting for sharing with providers and supporting accounting estimates.Drive strategic use of data to support business efficiencies and competitive decision-making.Review and provide guidance on actuarial estimates of IBNR, PDR and other actuarially determined assets and liabilities.Coordinate and review the work of outside actuaries to facilitate access to plan information necessary to support their work and ensure the company’s interests are represented.Financial Analytical Capacity and CapabilityWork with Information Systems to ensure access to a data source with high data integrity.Work collaboratively with the Business Intelligence department and other analysts to share best practices around using the data, ensure strong data governance and maintain a community of practice resource.Provide training and support to other Finance users around the data, software, and analytic approaches.AdministrationParticipate in 1:1, team, and department meetings.Attend All Staff meetings.Draft, recommend, and implement plans, policies, and procedures.Participate in Actuarial Services team goal setting.Train, mentor, and evaluate performance of assigned actuarial staff.Experience and/or EducationRequiredAssociate of the Society of ActuariesMinimum 5 years’ experience in an actuarial roleWork experience in health insurancePreferredFellow of the Society of ActuariesWork experience in Medicaid or MedicareKnowledge, Skills and Abilities RequiredKnowledgeWorking knowledge of other MS tools, including MS Office products, MS AccessStrong understanding of data systems and sources and how it impacts the data availableKnowledge of medical claims, billing practices and health insurance requirementsSkills and AbilitiesStrong data management skillsProficiency in SAS, SQL, or similar database querying toolsProficiency in MS ExcelHighly effective communication skills, including listening, verbal, and writtenWillingness to acquire new skillsAbility to effectively lead and participate on a variety of large projects, including complex initiatives across departmentsAbility to identify, implement, and lead process improvementsStrong ability in articulating and presenting information across multiple areas of the organizationAbility to communicate and present to external parties (e.g., auditors, actuaries, regulatory agencies) and stakeholders (e.g., Finance committees, Board of Directors, etc.)Ability to collaborate effectively with department managementStrong attention to detail and accuracyAbility to produce high quality outputAbility to effectively review others’ workAbility to identify problem, inconsistencies, unexpected results, relevant information, and uncertaintiesAbility to interpret and analyze information and implement conclusions/solutionsAbility to assist team members in developing conclusions and solutionsAbility to effectively prioritize own work and complete tasks on timeAbility to effectively collaborate with coworkers, leaders, executives, and stakeholdersAbility to learn from feedback and embrace changePossess a high degree of initiative, motivation, and professionalismAbility to maintain a positive attitudeAbility to work effectively with diverse individuals and groupsAbility to learn, focus, understand, and evaluate information and determine appropriate actionsAbility to accept direction and feedback, as well as tolerate and manage stressAbility to see, read, and perform repetitive finger and wrist movement for at least 6 hours/dayAbility to hear and speak clearly for at least 3-6 hours/dayWorking ConditionsWork Environment(s): ☒ Indoor/Office ☐ Community ☐ Facilities/Security ☐ Outdoor ExposureMember/Patient Facing: ☒ No ☐ Telephonic ☐ In PersonHazards: May include, but not limited to, physical and ergonomic hazards.Equipment: General office equipmentTravel: May include occasional required or optional travel outside of the workplace; the employee’s personal vehicle, local transit or other means of transportation may be used.Work Location: Work from homeWe offer a strong Total Rewards Program. This includes competitive pay, bonus opportunity, and a comprehensive benefits package. Eligibility for bonuses and benefits is dependent on factors such as the position type and the number of scheduled weekly hours. Benefits-eligible employees qualify for benefits beginning on the first of the month on or after their start date. CareOregon offers medical, dental, vision, life, AD&D, and disability insurance, as well as health savings account, flexible spending account(s), lifestyle spending account, employee assistance program, wellness program, discounts, and multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.). We also offer a strong retirement plan with employer contributions. Benefits-eligible employees accrue PTO and Paid State Sick Time based on hours worked/scheduled hours and the primary work state. Employees may also receive paid holidays, volunteer time, jury duty, bereavement leave, and more, depending on eligibility. Non-benefits eligible employees can enjoy 401(k) contributions, Paid State Sick Time, wellness and employee assistance program benefits, and other perks. Please contact your recruiter for more information.We are an equal opportunity employerCareOregon is an equal opportunity employer. The organization selects the best individual for the job based upon job related qualifications, regardless of race, color, religion, sexual orientation, national origin, gender, gender identity, gender expression, genetic information, age, veteran status, ancestry, marital status or disability. The organization will make a reasonable accommodation to known physical or mental limitations of a qualified applicant or employee with a disability unless the accommodation will impose an undue hardship on the operation of our organization.

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