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Actuarial Analyst (REMOTE)

MRI Irvine, CA

  • Expired: over a month ago. Applications are no longer accepted.
Job Description



Summary (Including Minimum Essential Position Duties):

This position is responsible for providing analytical support and analysis to different areas of the company, including Underwriting and Finance. The position will serve as the actuarial data expert to support current and future business initiatives.

· Review and analyze group P&L information to determine potential risk and trends, as well as identify any issues with utilization, eligibility, reporting, underwriting or system issues.

· Complete monthly/quarterly group claims reporting for external groups and research inconsistencies. Work with Utilization Management Department to enhance utilization reporting and analyze aberrant utilization patterns.

· Work with programmer on requirements to automate standard reporting, as well as testing new programs prior to release.

· Work with Provider Services to determine rating impact of different provider financial arrangements.

· Perform ad-hoc reports to support analysis of utilization, provider compensation, group profit/loss, and trending.

· Lead on-going analyses of financial, budgetary or dental claims data, through forecasting, statistical analyses, trending, regression analyses, risk assessment, and utilization assessment.

· Identify key issues and trends, escalating as needed. Use actuarial concepts and internal policies and procedures to solve problems or provide suggestions.

· Construct financial models to support operational initiatives and analytical activities and enable decision-making on business and strategic concerns/goals.

· Provide on-going financial analyses and consolidate a wide-range of projections for the development of short- and long-term strategic goals.

· Generate and distribute regularly scheduled reports. Review and organize actuarial and operational data for reports. Utilize statistical tools to monitor and provide ongoing analysis of the reports and associated data. Responsible for the preparation of complex reports.

· Lead and/or participate in a variety of special studies and ad hoc analyses in support of departmental, business, and/or clinical objectives.

· Participate in meetings and project teams. Communicate and present financial analyses and models to appropriate audiences. Perform ad-hoc reports to support analysis of utilization, provider compensation, group profit/loss, and trending.


Education and/or Experience:

· Bachelor’s degree in mathematics/science/statistics or business-related field or equivalent experience

· Certified Actuary with minimum ASA certification

· Minimum 5 years of experience in managed care data analysis

· Underwriting and/or Claims experience a plus


Specific Skills/Knowledge:

· Knowledge of CMS regulations a plus

· Ability to work on multiple, concurrent tasks

· Advanced skills in Microsoft Access and Excel

· Basic knowledge of SQL and Crystal Reports preferred


Why Work Here?
Benefits and PTO after 90 days.

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Irvine, CA


Finance and Insurance

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