Jobs

Reporting directly to the CFO, Sr Actuarial Analyst monitors claims trends and investigates aberrations, tracks member risk scores to support risk adjustment analysis, and on-going analysis and monitoring of utilization targets. Assists in actuarial filings such as the Statement of Actuarial Opinion and ACA Marketplace rate filings. The Senior Actuarial Analyst helps to coordinate between external consultants and internal staff on annual Medicare Advantage rate filings and assess the Texas Health & Human Services Commission’s (HHSC) development of the annual Medicaid rates. Supports the annual budget process and reviews work papers of other Finance staff as needed. The Senior Actuarial Analyst will also provide ad hoc assistance to senior level management as needed.

-   Completes financial forecast scenario modeling to evaluate and ensure corporate financial health. 

-   Creates monthly claims liability estimates for all business segments, for review by the Chief Financial Officer

-    Analyzes internal and external issues affecting claims payments/processing and initiate analyses on additional items with focus on establishing an adequate claims reserve level. 

-    Assists the Finance department with regulatory filings including quarterly and annual health statement filings and medical loss ratio reporting. 

-    Assists in actuarial filings such as the Statement of Actuarial Opinion and ACA Marketplace rate filings. 

-    Coordinates between external consultants and internal staff on annual Medicare Advantage rate filings and assess HHSC’s development of the annual Medicaid rates. 

-    Supports the annual budget process and reviews work papers of other Finance staff as needed. 

Qualifications 

Bachelor’s degree in Actuarial Science, Mathematics, or another related field preferred.

3+ years of experience in health insurance industry in an analyst role

Preference for 3 or more Society of Actuaries Exams passed (employer will support ongoing exams).

Proficiency in Excel and some computer coding (SQL/SAS) experience is required.

Strong analytical skills and experience with medical claims trends, reserving, forecasting, and pricing.

Ability to communicate complex analytical results effectively.

Experience with Medicaid, Medicare and/or Marketplace product is a plus but not required.