Senior Actuarial Analyst

Who We Are

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities. To learn more about who we are at Point32Health, click here.

Job Summary

Senior Actuarial Analyst will support the financial Forecasting and Pricing needs for Medicare Supplement Products as well as the Forecasting and Reporting for Medicare Part D. This role will work closely with the Finance departments during monthly closing as well as quarterly and annual reporting. This role will also work with various business partners outside of Actuarial in the annual financial planning cycle.
A thorough understanding of the health insurance industry as well as proficiency in Excel and statistical modeling is required. The position is eligible to participate in the Actuarial Student Program, including job rotations ever 18-24 months and comprehensive support of the pursuit of Fellowship in the Society of Actuaries.

Key Responsibilities/Duties – what you will be doing

Support the analysis and data needs for a broad range of financial and actuarial functions. This support will include rate reviews, financial planning and projections, trend analysis, product development, provider reimbursement analysis, fee schedule development, provider risk analysis, and medical cost containment analysis. This role will work closely with a variety of THP departments including underwriting, sales, contracting, and medical management.

Multifaceted position that allows the individual to participate in all aspects of projects from planning, designing, implementing, and presenting findings. Projects are focused on the Medicare Preferred population and support the goal of providing a value based product that is competitively priced and increases the quality of care provided to our members. The individual will meet these needs through the use of various software packages including SAS, Excel, Access, and PowerPoint. The use of other specialty software is also required. Day-to-day work is a combination of new projects, maintaining existing projects, and standard reporting.

Qualifications – what you need to perform the job

Qualifications (Minimum education & experience level required):

College degree required

3+ years experience

2-4 exams

Skill requirements (include complexity of position):

Analytic:

Demonstrated experience in analytic work

Technical:

Proficiency in the use of personal computers, MS Excel, relational databases or statistical packages such as SAS. A solid understanding of SQL is a plus.

Communication/Presentation skills:

Well-developed verbal and written skills

Ability to facilitate planning and review sessions

Developing presentation skills, presents mostly within department and to project teams

Negotiation/Leadership skills:

Able to operate in a matrix environment

Able to implement Actuarial department standards and processes.

Independence/Judgment:

Receives regular management oversight of selected tasks, projects and processes

Increasingly applies own judgment to analytical/technical issues

Interpersonal skills (include personal interaction):

Must be able to work cooperatively as a team member. Regular interface with various levels of staff and management is required as well.

Confidential data:

All information (written, verbal, electronic, etc.) that an employee encounters while working at Tufts Health Plan is considered confidential. Will be exposed to and required to deal with highly confidential and sensitive material. Must adhere to corporate compliance policy, department guidelines/policies and all applicable laws and regulations at all times.

Working Conditions or Additional requirements (include special requirements, e.g., lifting, travel, overtime)

Unlimited access to confidential member and provi