Actuary Specialist - Actuarial Cost Insights (Remote)

UPMC; Pittsburgh (Allegheny County); Hybrid; USD 120,000 - 180,000; Full time

Job summary

UPMC Health Plan is seeking an Actuary Specialist in the Department of Health Economics. This credentialed actuary will independently own and execute sophisticated analyses, identify opportunities, and influence strategic decisions around trend drivers.

The role may be fully remote or hybrid for candidates based in Pittsburgh, PA. It requires leading actuarial analyses, presenting results to leadership, and mentoring staff while collaborating across analytics, product, and finance teams.

Qualifications

• Actuarial expertise in health economics and analytical modeling.
• Strong data analytics and statistical software skills.
• Ability to influence strategy through leadership and cross-functional collaboration.
• Experience presenting to leadership and clinical/finance teams.

Responsibilities

• Drive sophisticated actuarial analyses of medical cost utilization and unit cost data.
• Lead development of actuarial and financial tools to communicate financial drivers to leadership.
• Present findings to leadership and clinical teams to inform decisions.
• Supervise or mentor junior actuarial staff as needed.
• Analyze affordability initiatives on cost and utilization trends and propose mitigations.
• Develop well-documented actuarial reports and maintain data transparency.

Job description

Purpose:

UPMC Health Plan is seeking an Actuary Specialist in its Department of Health Economics! This credentialed healthcare actuary would independently own and execute sophisticated actuarial analyses, apply industry expertise to identify opportunities, and influence strategic decisions around trend drivers. This includes leading the process of analyzing medical cost utilization and unit cost data, identifying top trend drivers and affordability opportunities, and frequently presenting findings to leadership.

The Actuary Specialist will require a diverse set of skills and experience, including data and analytics expertise, broad-based business and health economics acumen, a strategic mindset, and an ability to influence and leverage cross-functional teams in a non-traditional actuarial environment. This position may also direct or supervise less experienced actuarial analysts in the performance of duties.

As an Actuary at UPMC, you will be given support for professional designations through our comprehensive student program and continuing education opportunities. Our team members can choose a work style that is best for them - this position is eligible for fully remote work or a hybrid work arrangement for candidates based in Pittsburgh, PA.

Responsibilities:

• Drive creative problem-solving and strategic decision-making involving medical cost improvement strategies.


• Lead the development of detailed actuarial and financial tools to communicate drivers of financial performance to facilitate corporate decision-making and the development of cost mitigation strategies.


• Lead the monthly Leading Indicator process detailing emerging results and present results to clinical teams to support timely intervention and decision-making.


• Independently lead the design, development, and execution of complex actuarial analyses that translate business questions into actionable insights and strategic recommendations.


• Lead the analysis for analyzing the impacts of healthcare affordability initiatives on medical cost and utilization trends.


• Apply analytical and statistical software tools to summarize large healthcare data to glean findings and actionable insights and deliver results to leadership.


• Forecast and interpret financial results, including variances from budget, to help identify medical cost improvement opportunities and potential risks.


• Analyze trends in spending and utilization using healthcare claims data.


• Develop and gain support for data-based recommendations with team members from product, clinical, network, and strategy functions.


• Lead the development of well-documented standard actuarial reports and projects.


• Frequently present results of analyses and recommendations to management and senior leaders and lead the completion of follow-ups and next steps.


• Apply an understanding of complex actuarial concepts, methods, and applications in a variety of situations.


• Creatively leverage a wide range of datasets to inform key analyses.


• Provide direction and supervision to less experienced staff in the performance of duties. May directly manage 1 analyst.


• Build strong relationships with Actuarial, Analytics, and Finance teams across the enterprise.


• Ensure that departmental work products meet the highest standards of quality.