Actuarial Analyst IV

Job Description:

Summary:

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. This role is amongst the group that is responsible for providing a range of experience working to establishing rates, rating structures and systems and reserves. The Actuarial Analyst has accountability to providing in depth analysis on the overall risk management and financial solvency for the health plan operation.

Essential Accountabilities:

Level I

• Establishes insurance rates, rating structures, and rating systems for groups and categories of business.
• Maintains reserve programs, pricing files, risk score models, benefit relativity tables and appropriate documentation for work.
• Develops financial projections, risk score analysis, unpaid claim liability estimates and conducts actuarial analysis for well-defined projects as directed.
• Compiles and analyzes data to draw conclusions and make recommendations.
• Proposes and assists in the development of process improvements utilizing system and software applications to full potential and participates in activities and projects as directed.
• Continued professional growth in Actuarial field as evidenced by participation in the Actuarial Study Program, attainment of credentials, and maintaining applicable annual continuing education requirements.
• Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values, adhering to the Corporate Code of Conduct, and leading with the Lifetime Way values and beliefs.
• Consistently adheres to the Actuarial Standards of Practice and the Code of Professional Conduct as promulgated by the Actuarial Standards Board
• Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.
• Regular and reliable attendance is expected and required.
• Performs other functions as assigned by management.

Level II (in addition to Level I Accountabilities)

• Conducts analyses for and communicates with other departments on various initiatives.
• Assists the development of actuarial analyses concerning complex issues & trends, coordinates with staff.
• Reconciles Data Warehouse data with corporate financials or encounter submissions and identifies and develops corrective action with regards to Data Warehouse integrity issues.
• Initiates and leads efforts to continually improve data capabilities and quality of department analysis and reporting.
• Proactively and independently ideates process improvements, resea...

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