Job ID 20000J77
Available Openings 1
PURPOSE AND SCOPE:
- Leads actuarial decisions that support contracting for related FHP health plans, ACOs, ESCOs, C-SNPs and other risk arrangements. Delivers actuarial analyses in support of pricing, reserving, provider contract development, and product development. Manages internal and external client workflows, presents technical materials to clients, develop
- CMS required reserve amounts, monthly revenue and reserve estimates in support of financial reporting and related bid submissions.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Performs assigned actuarial analyses tasks in support of but not limited to pricing, reserving, provider contract development, and product development. Utilizes actuarial systems and programming skills to access and organize the data, perform applicable actuarial calculations, analyze moderate to complex information, assess reasonability of results, draw conclusions, update exhibits and slides, and finalize documentation.
Manages the tactical execution of short- and long-term objectives through the coordination of actuarial analyses activities with a direct responsibility for results, including costs, methods, and staffing.
Technically proficient in the actuarial analysis and has knowledge of industry practice and business principles. Works on issues of diverse scope where analysis of situation or data requires evaluation of a variety of factors, including an understanding of current business trends. Has a larger range within the actuarial analysis department.
Performs research and collection of data, including data mining and reporting, which is provided to various customers inside and outside the department.
Develops related CMS required reserve amounts and MA bid submissions.
Supports actuarial projects relating to complex issues and trends, coordinates with several different disciplines and staff.
Drives efforts to continually improve data capabilities and quality of department analysis and reporting.
Leads development of related pricing methodologies, analysis of the Plan's risk pool and identification of trends in FMC's cost structure.
Possesses an extensive understanding of the data available within the company, the health care market, applicable actuarial techniques, and changes in the health care legislation.
Provides leadership, coaching and development plans for all direct reports to maintain an engaged and productive workforce; partnering with Human Resources on employee matters.
Provide technical guidance.
Assist with various projects as assigned.
- Other duties as assigned.
Additional responsibilities may include focus on one or more departments or locations. See applicable addendum for department or location specific functions.
PHYSICAL DEMANDS AND WORKING CONDITIONS:
- The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- May be responsible for the direct supervision of various levels of actuarial staff.
- Bachelor's Degree required; Advanced Degree desirable
- ASA or progress towards ASA designation preferred
EXPERIENCE AND REQUIRED SKILLS:
- 6 – 8 years' related experience.
- 3+ years' supervisory or medical advantage, government programs experience preferred.
- Excellent oral and written communication skills.
- Detail oriented with strong analytical and organizational skills.
- Strong computer skills with demonstrated proficiency in word processing, spreadsheet, database, presentation and email applications.
- Strong interpersonal skills with the ability to communicate with all levels of management through diplomacy and tact.
- Demonstrated proficiency with related programming and business intelligence systems (e.g., SQL, SAS or similar).
EO/AA Employer: Minorities/Females/Veterans/Disability/Sexual Orientation/Gender Identity
Fresenius Medical Care North America maintains a drug-free workplace in accordance with applicable federal and state laws.
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