Actuarial Analyst III - Provider Reimbursement (Remote)

Resp & Qualifications PURPOSE: The Actuarial Analyst III will perform individual project tasks as requested, execute calculations of moderate complexity, and understand concepts of actuarial analysis that are of varying complexity. The incumbent is responsible for utilizing various sources to procure data and then turning that data into meaningful information, as well as fulfilling ad hoc requests. ESSENTIAL FUNCTIONS: • Reviews and organizes actuarial and operational data for use in a variety of actuarial analyses that may include rate filings, financial forecasts, IBNR analysis, trend analysis, provider contract analysis, etc. Utilizes statistical tools to monitor and provide ongoing analysis. Prepares complex reports and/or actuarial models. Documents data sources, assumptions, and methods. Responsible for developing/updating SOPs related to actuarial analyst duties. • Prepares accurate and timely reports as assigned. These reports may be related to internal analysis or may external in nature (statutory and regulatory). • Participates and works collaboratively in a variety of special studies and ad hoc analyses in support of departmental business and/or clinical objectives. Makes recommendations based on actuarial assumptions and methodologies. Presents analyses and recommendations in a polished and professional manner to internal and/or external customers. Researches and resolves data integrity issues. Partners with other team members to solve problems. Provide guidance and mentorship to junior staff members. • Makes progress toward ASA/FSA designation with the Society of Actuaries by passing SOA exams, completing modules, and/or obtaining validation by educations experience (VEE) credits.

Qualifications

Education Level: Bachelor's Degree in Actuarial Science, Finance, Mathematics, or related math field. In lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience. Experience: 3 years health insurance actuarial experience Preferred Qualifications: • Passage of 3 exams • Experience with value-based contracting arrangements Knowledge, Skills and Abilities (KSAs) • Familiarity with actuarial, mathematical and statistical procedures and practical applications. • Highly analytical and a general understanding of health insurance products and markets. • Strong conceptualization skills. • Solid interpersonal, verbal & written communication skills, to the point where actuarial information can be completely & concisely presented to both an actuarial and non-actuarial audience. • Ability to use models and tables to evaluate large data sets. • Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence. Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging. Salary Range: $74,088 - $147,147 Salary Range Disclaimer The disclosed range estimate has not been adjusted for the applicable geographic differential associated with the location at which the work is being performed. This compensation range is specific and considers factors such as (but not limited to) the scope and responsibilites of the position, the candidate's work experience, education/training, internal peer equity, and market and business consideration. It is not typical for an individual to be hired at the top of the range, as compensation decisions depend on each case's facts and circumstances, including but not limited to experience, internal equity, and location. In addition to your compensation, CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements). Department Actuarial Product Pricing Equal Employment Opportunity CareFirst BlueCross BlueShield is an Equal Opportunity (EEO) employer. It is the policy of the Company to provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information. Where To Apply Please visit our website to apply: www.carefirst.com/careers Federal Disc/Physical Demand Note: The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes him/her ineligible to perform work directly or indirectly on health care programs. PHYSICAL DEMANDS: The associate is primarily seated while performing the duties of the position. Occasional walking or standing is required. The hands are regularly used to write, type, key and handle or feel small controls and objects. The associate must frequently talk and hear. Weights up to 25 pounds are occasionally lifted. Sponsorship in US Must be eligible to work in the U.S. without Sponsorship. #LI-CB1 Apply Job!