Actuarial Analyst II: Pricing, Forecasting & Health Claims

61000 SelectHealth Inc; Oklahoma; On-site; USD 70,000 - 110,000; Full time

Benefits offered by this job

Comprehensive benefits package

PEAK program for education support

Job summary

Intermountain Health is seeking an experienced actuarial professional to lead data analytics, pricing, rate filings and reimbursement design across lines of business. This role directs development of forecasts, reserves, and financial reporting to support strategic decisions.

The position emphasizes collaboration, risk adjustment analysis, budget modeling, and provider reimbursement insights, with a focus on ACA and Medicare filings and audits.

Qualifications

• Bachelor's degree in math, statistics, computer science, economics or finance obtained through an accredited institution.
• Education is verified.
• Associate of the Society of Actuaries and four years of relevant actuarial experience.

Responsibilities

• Provides direction for pricing, rate filings and designs for all lines of business.
• Coordinates development of annual required rate filings for ACA and Medicare.
• Coordinates risk adjustment analysis and accrual development.
• Provides direction and oversight for the development and maintenance of analysis, forecasting, and reporting of claims experience and trends, both in aggregate and various components.
• Analyzes and develops financial statement reserves and other liabilities, contingent settlements, incentive and risk-share payments, reinsurance claims and other third-party claims and liabilities, etc.
• Provides input and support for internal and external audits and reporting.
• Provides direction and oversight of development and maintenance of analysis, forecasting, administrative models, and reporting of budget projection inputs, both in aggregate and various components.
• Provides direction and oversight of development, analysis, and reporting of facility, physician, and other provider reimbursement structures, models and service utilization information.
• Coordinates and develops Retiree Drug Subsidy data reporting and submissions.
• Designs, develops, and maintains data extracts and complex queries and online data analysis and reporting tools.

Skills

Analytical Thinking

Management Reporting

Product Development

Analytic Software Programs

Teamwork

Intermediate SQL

Stop Loss Calculations

Communication of results

Actuarial Health Knowledge

Finance Statements

Education

Bachelor's degree in math, statistics, computer science, economics or finance obtained through an accredited institution.

Associate of the Society of Actuaries and four years of relevant actuarial experience

Job description

Intermountain Health is seeking an experienced actuarial professional to lead data analytics, pricing, rate filings and reimbursement design across lines of business. This role directs development of forecasts, reserves, and financial reporting to support strategic decisions.

The position emphasizes collaboration, risk adjustment analysis, budget modeling, and provider reimbursement insights, with a focus on ACA and Medicare filings and audits.