Actuarial Analyst II (Risk Adjustment)

Job Summary:

The Actuarial Analyst II is responsible for providing timely, accurate, and actionable data, analysis and recommendations supporting the department, area, and corporate key initiatives.

Essential Functions:

• Develops actionable recommendations to management relative to all analysis
• Calculates profitability reports on appropriate business segments
• Leads regular and ad-hoc analysis identifying opportunities to improve efficiency and affordability
• Leads regular and ad-hoc analysis/studies to evaluate assumptions used in other processes
• Participates in cross functional teams to address key issues facing the organization
• Prepares monthly calculation of the company's IBNR reserves
• Evaluates government reimbursement process to determine areas of risk and opportunity
• Participates in initiatives to improve operating results
• Initiates key analysis to improve overall MLR results
• Performs other duties as assigned

Education and Experience:

• Bachelor's degree in actuarial science, mathematics, economics or a related field is required
• Minimum of one (1) year of decision support or financial analysis experience is preferred
• Intermediate database (SAS or Access) experience is required
• Managed Care or healthcare experience is preferred
• Risk Adjustment experience is highly preferred
• Medicaid experience is preferred

Competencies, Knowledge and Skills:

• Intermediate interpersonal/verbal communication skills and a high level of professionalism
• Intermediate written communication skills
• Intermediate ability to work independently and within a team environment
• Intermediate ability to work in fast paced environment with changing priorities
• Intermediate ability to remain calm under pressure
• Intermediate proficiency level with Microsoft Excel
• Intermediate proficiency with Microsoft Suite to include, Word, Power Point and Outlook
• Intermediate ability to effectively present information and respond to questions from peers and management
• Intermediate ability to analyze and interpret financial data in order to coordinate the preparation of financial records
• Intermediate knowledge of SQL, SAS, R, or other data manipulation software
• Effective problem-solving skills with attention to detail
• Effective listening and critical thinking skills

Licensure and Certification:

• A combination of years of industry experience and exams passed under the Society of Actuaries Exam Syllabus (excluding exam SRM via transition credit) equaling 5 or more is required
• Active pursuit of an actuarial designation (ASA) is required

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time

Compensation Range:

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Organization Level Competencies

• Create an Inclusive Environment

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• Understand the Business