Senior Actuarial Analyst

WellSense Health Plan; Boston (MA); Hybrid; USD 89,000 - 129,000; Full time

Benefits offered by this job

Medical, dental, vision benefits

Pharmacy benefits

Flexible Spending Accounts

403(b) matching

Paid time off

Career advancement opportunities

Wellbeing resources

Job summary

WellSense Health Plan in Boston, MA is seeking a Senior Actuarial Analyst to join the Finance / Actuarial Services team. The role involves applying mathematics, statistics, and business principles to support rating, pricing, reserving, financial forecasting, and healthcare data analytics under minimal supervision.

You will analyze data, lead rate development, assist regulatory filings, and contribute to IBNR reserves and financial projections, collaborating with multiple departments to improve

Qualifications

• Bachelor’s degree or commensurate educational experience in related field.
• ASA or FSA designation is preferred.
• Experience in actuarial analysis, data modeling, and healthcare data analytics is required.
• Background in managed healthcare or insurance operations is a plus.

Responsibilities

• Analyze financial, statistical and mathematical data and perform actuarial calculations.
• Lead or support rate development through analyses of benefit design and claims experience.
• Lead or support regulatory rate filings and data for inquiries.
• Develop monthly IBNR reserve estimates for different lines of business.
• Prepare monthly accruals and contract settlements for different lines of business.
• Support financial budgets, reforecasts, and other projections.
• Evaluate capitation rates for Medicaid programs or other programs.
• Lead or assist risk adjustment analyses and risk score simulations.
• Develop trend analyses and provider contract analytics.

Skills

MS Office

SQL

SAS

Excel

Healthcare data

Education

Bachelor’s Degree in Mathematics/Actuarial Science/Finance/Economics

ASA or FSA

Tools

SQL

SAS

Job description

Job Summary:

The Senior Actuarial Analyst is a key member of the Finance / Actuarial Services team.With minimum guidance and supervision, the Senior Actuarial Analyst applies knowledge of mathematics, probability, statistics, and principles of business in order to provide assistance and technical support for more extensive rating/pricing, reserving, medical economics, financial forecasting, and/or healthcare data analytics. The Senior Actuarial Analyst works with a team of actuaries to assure a coordinated approach to the actuarial components of health programs, and provides actuarial support to Finance, and/or other departments in the company.

Key Functions/Responsibilities:

• Analyzes financial, statistical and mathematical data and performs actuarial calculations
• Leads or supports the rate development through analyses of benefit design, rating factors, claims experience, regulatory mandates, admin expense allocation, and projection of future claim cost
• Leads or supports regulatory rate filings, and prepares data for additional inquiries and requirements
• Leads or supports the development of monthly IBNR reserve estimates for different line of business
• Prepares monthly accruals and contract settlements for different line of business
• Leads or supports financial budget, reforecast and other financial projections
• Evaluates and makes recommendations regarding the adequacy of capitation rates from state Medicaid programs or other new program
• Leads or assists in risk adjustment analyses and risk score simulations
• Leads or supports trend development, trend drivers study, and/or provider contract analytics
• Maintains established reports for internal needs or regulatory requirements
• Participates in internal and external audits
• Participates in requirements gathering for and serves as delegate or backup for corporate initiatives/projects
• Generates ideas and analytical approaches for corporate initiatives/projects
• Designs or updates SQL/SAS queries and programs to extract data from data warehouse, and reviews the data to ensure accuracy and validity
• Advises Finance department on data warehouse design, requests and works with IT to establish priorities
• Initiates and leads efforts to improve quality and efficiency of actuarial models, analyses and reports
• Summarizes findings and recommendations, documents the process
• Develops presentations and communicates to senior management or external parties
• Shares knowledge and provides training to new employees

Qualifications:

• Bachelor’s Degree in Mathematics, Actuarial Science, Finance, Economics or related fields
• At least 4 years of progressively responsible experience in actuarial analysis, data modeling, informatics and analysis
• Commensurate educational experience in related field will be considered
• A background in managed healthcare, insurance operations
• ASA or FSA

Competencies, Skills, and Attributes :

• Should be experienced in MS Office products, SQL, and SAS or other statistical software
• Should be proficientin Excel
• Should be an experienced user of healthcare data
• Ability to meet deadlines, multi-task, problem solve and use appropriate technology to analyze business problems
• Ability to work collaboratively with team members and other departments
• Strong communications skills

Compensation Range

$88,500 - $128,500

This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer. This includes education, experience, skills, and certifications/licensure as they directly relate to position requirements; as well as business/organizational needs, internal equity, and market-competitiveness. In addition, WellSense offers generous total compensation that includes, but is not limited to, benefits (medical, dental, vision, pharmacy), merit increases, Flexible Spending Accounts, 403(b) savings matches, paid time off, career advancement opportunities, and resources to support employee and family wellbeing.

Note

This range is based on Boston-area data, and is subject to modification based on geographic location.

About WellSense

WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members.

Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability or protected veteran status. WellSense participates in the E-Verify program to electronically verify the employment eligibility of newly hired employees