Actuarial Analyst I​/II​/III​/IV

Job Overview

The Actuarial Analyst performs actuarial services in support of Health Plan operations and monitors and maintains financial solvency through the understanding of current data & environment and modeling of future events. The role is part of a group responsible for establishing rates, rating structures, systems, and reserves, and provides in‑depth analysis on overall risk management and financial solvency of the health plan operation.

• Establish insurance rates, rating structures, and rating systems for groups and categories of business.
• Maintain reserve programs, pricing files, risk‑score models, benefit relativity tables and appropriate documentation.
• Develop financial projections, risk‑score analysis, unpaid claim liability estimates and conduct actuarial analysis for well‑defined projects as directed.
• Compile and analyze data to draw conclusions and make recommendations.
• Propose and assist in the development of process improvements utilizing system and software applications and participate in activities and projects as directed.
• Continue professional growth in the Actuarial field as evidenced by participation in the Actuarial Study Program, attainment of credentials, and maintenance of applicable annual continuing education requirements.
• Demonstrate high standards of integrity by supporting the company’s mission and values, adhering to the Corporate Code of Conduct, and leading with the company values and beliefs.
• Consistently adhere to the Actuarial Standards of Practice and the Code of Professional Conduct as promulgated by the Actuarial Standards Board.
• Maintain high regard for member privacy in accordance with corporate privacy policies and procedures.
• Maintain regular and reliable attendance.
• Perform other functions as assigned by management.

• Conduct analyses for and communicate with other departments on various initiatives.
• Assist development of actuarial analyses concerning complex issues & trends, and coordinate with staff.
• Reconcile Data Warehouse data with corporate financials or encounter submissions and identify and develop corrective actions regarding Data Warehouse integrity issues.
• Initiate and lead efforts to continually improve data capabilities and quality of department analysis and reporting.
• Proactively and independently ideate process improvements, research, and recommend changes to actuarial processes.
• Draw together facts and input from a variety of sources.

• Review and ensure pricings are consistent with established profitability targets for business segments priced in Actuarial.
• Develop actuarial analyses concerning complex issues and trends, coordinating with several disciplines and staff.
• Provide effective technical advice and support to assist management in meeting corporate goals and identifying strategy, involving other departmental areas.
• Lead departmental projects and initiatives with other actuarial staff.
• Prepare actuarial statements of opinion.

• Represent the Actuarial Department on special projects involving other areas of the company or external constituents.
• Perform data exploration using a combination of statistical programming languages and deploy advanced statistical techniques to improve risk prediction, reserves, trend and financial forecasting in an actuarially sound manner and enable real‑time results and operational efficiencies.
• Lead organizational projects with internal and external partners.
• Interpret how regulatory changes affect the Health Plan and develop impact analyses, processes and guidelines.
• Collaborate with senior leadership in meeting corporate goals and strategic planning and decision making.
• Recommend departmental annual performance goals.

All Levels

• Bachelor’s Degree in a related field with at least one (1) Society of Actuary (SOA) exam passed required.
• Prior actuarial or related insurance industry experience preferred.
• Strong analytical skills, verbal and written communication skills.
• Strong interpersonal skills with demonstrated ability and…