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Actuarial Analyst II - Remote (Select States)

Sentara Health Plans Community Care, United States

City/State

Norfolk, VA

Work Shift

First (Days)

Overview:

Sentara Health is currently seeking a full-time remote Actuarial Analyst II.

Remote opportunities available in the following states: Virginia, North Carolina, Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington (state), West Virginia, Wisconsin, Wyoming

For those located in Washington State, and Maryland the following salary range applies: $74,321.52 - $111,493.20

Job Description Summary

This role will be within an Actuarial department, focusing on Government Programs. 

Assist in any and all of the functions normally associated with a qualified health actuary including: IBNR calculation; the determination of rating factors such as age, sex, location, or industry; development of rates and filings for the BOI; suggestions for periodic group rating changes; development of necessary rates for government programs; assistance with the development, implementation and maintenance of new products, services and systems, including any necessary rate development; providing actuarial input to the Corporate management staff level; and reporting on the financial status of entire products or segments of products.

Job Duties:

  • Create models that identify and predict diseases in our members.

  • Generate forecasts of risk adjusted revenues for year-end accruals.

  • Maintain data structures that house HCC models and member data.

  • Measure key metrics related to point-of-care gap closure solutions.

  • Valuate the financial impact of risk-adjustment operations.

  • Assist in ad-hoc requests related to risk scores and revenue.

  • Advise on the strategic considerations of risk-adjustment activities.

  • Develop new processes that improve on the department's objectives.

  • Work with a team of actuaries, analysts, and medical professionals.

Required Education:

Bachelor's level degree

Job Requirements:

Minimum 2 years in Actuarial Analysis. Analytical and problem-solving skills are necessary; ability to work under tight deadlines and handle pressure situations; ability to work in a team environment.

Minimum completion of three Actuarial exams with continued progress towards Society of Actuaries credential

Experience in at least 3 of the following areas:

  • IBNR and reserve setting

  • General pricing and filing support of Individual products

  •  General pricing and filing support of Small Group products

  • General pricing and filing support of Large Group products

  • Assist in Medicare Advantage Bid filing

  • Evaluation of Managed Medicaid programs

  • Provider Contract evaluations

  •  Provider Profit/withhold settlement evaluations

  • Product Experience Monitoring

  • Reinsurance/Stop-loss Reporting

Sentara Benefits:

Sentara employees strive to make our communities healthier places to live. We’re setting the standard for medical excellence within a vibrant, creative, and highly productive workplace. For more information about our employee benefits, https://www.sentaracareers.com/explore-sentara/benefits/

Join our team, where we are committed to quality healthcare, improving health every day, and provide the opportunity for training, development, growth!

We provide market-competitive compensation packages, inclusive of base pay, incentives, benefits, and equity. The base pay rate for Full Time employment is:$60,756.80-$101,254.40

Benefits: Caring For Your Family and Your Career• Medical, Dental, Vision plans• Adoption, Fertility and Surrogacy Reimbursement up to $10,000• Paid Time Off and Sick Leave• Paid Parental & Family Caregiver Leave • Emergency Backup Care• Long-Term, Short-Term Disability, and Critical Illness plans• Life Insurance• 401k/403B with Employer Match• Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education• Student Debt Pay Down – $10,000• Reimbursement for certifications and free access to complete CEUs and professional development•Pet Insurance 
•Legal Resources Plan
•Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.

Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.


In support of our mission “to improve health every day,” this is a tobacco-free environment.

For positions that are available as remote work, Sentara Health employs associates in the following states:

Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.

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Job Profile

Regions

North America

Countries

United States

Restrictions

Alabama Delaware Florida Georgia Idaho Indiana Kansas Louisiana Maine Maryland Minnesota Nebraska Nevada New Hampshire North Carolina North Dakota Ohio Oklahoma Pennsylvania Remote Remote only in select states South Carolina South Dakota Tennessee Texas Utah Virginia Washington State West Virginia Wisconsin Wyoming

Benefits/Perks

401k/403b 401k/403b with employer match 403b Adoption reimbursement Annual discretionary bonus Dental Development Disability Disability coverage Emergency backup care Healthcare Life Insurance Medical Paid parental leave Paid Time Off Pet Insurance Quality healthcare Remote work Sick Leave Student debt pay down Training Tuition Assistance Vision Vision plans

Tasks
  • Advise on risk-adjustment strategies
  • Assist with ad-hoc requests
  • Collaborate with team
  • Create disease prediction models
  • Develop new processes
  • Evaluate financial impacts
  • Generate risk-adjusted revenue forecasts
  • Maintain data structures
  • Measure key metrics
  • Monitoring
  • Reporting
Skills

Actuarial Analysis Analysis Analytical Data Modeling Deadline management Financial evaluation Forecasting Government programs Healthcare IBNR calculation Implementation IT Management Medicaid Medicare Operations Problem-solving Reimbursement Reporting Risk Adjustment Support Team Collaboration Training

Experience

2 years

Education

Associates Bachelor's Bachelor's degree

Certifications

Society of Actuaries credential

Timezones

America/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9