Health First

Job Requirements

Job Description

To be fully engaged in providing Quality/No Harm, Customer Experience, and Stewardship by providing statistical data analysis/support and construct probability tables to forecast risk and liability. Support product rate filings, reserve calculations, group underwriting and experience reporting, to make price decisions. Support the financial management of the health plan through medical cost and revenue projections predominantly through the use of Excel. Explain complex technical matters as needed.

PRIMARY ACCOUNTABILITIES

Support and developed financial models for the monitoring and projection of current and future business.

Maintain rating models and data base support programs used in the Underwriting department

Develop and maintain models for the calculation of appropriate claims and other reserves.

Submit weekly report showing progress on current projects

Demonstrate dependability, flexibility and a high level of job interest.

Consistently seek ways to improve operational and financial efficiencies through better use of resources.

Contribute to development and maintenance of management reports necessary for the financial management of all products.

Filing Support: support the development of required state and federal premium rates and other filings.

Product Support: assist in development and pricing of new products and product enhancements. Collaborate with Decision Support, Underwriters, Claims, and Senior Management to develop plans for new lines of business or improve existing business.

Financial Support: assist in the determination of cash reserves (IBNR), budget projections and all other financial modeling including development of provider payment mechanisms

Group Services Support: support the design, review, administration, and regulatory compliance of health insurance plans in the delivery to specific employer groups.

Underwriting Support: assist in development and pricing of existing and proposed Large Group business including support of pricing models.

Work Experience

Qualifications

• BS or BA degree in Mathematics or Actuarial Science from accredited college or university.
• 3.4 GPA in college or university required.
• Possess strong computer abilities with emphasis on Microsoft Excel, SQL or other programming language desired.
• Passed two actuarial exams.
• Knowledge of laws, government regulations, and agency rules for managed care controls.
• Some level of understanding of insurance and associated terminology.
• Strong background in arithmetic, algebra, geometry, calculus, statistics, and their applications.
• Knowledge of economics and accounting principles and practices, and reporting of financial data.
• Knowledge of document structure and content, including spelling, grammar and rules of composition.
• Be able to perform support tasks under limited supervision by HF Actuary for at least one of the following responsibilities as described above: Filing, Financial, Group Services, or Underwriting.
• Has demonstrated an ability to work directly with Underwriting, Risk Adjustment, Finance, Decision Support, Group Services and/or Senior Management.
• Minimum of 6 months of experience in at least one of the following support responsibilities as described above: Filing, Financial, Product, Group Services, or Underwriting.

Benefits

At Health First, diversity and inclusion are essential for our continued growth and evolution. Working together, we strive to build and nurture a culture that recognizes, encourages, and respects the diverse voices of our associates. We know through experience that different ideas, perspectives, and backgrounds create a stronger and more collaborative work environment that delivers better results. As an organization, it fuels our innovation and connects us closer to our associates, customers, and the communities we serve.