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Manager, Corporate Actuarial Support

Company: Harvard Pilgrim Health Care
Location: Wellesley, MA
Posted on: April 7, 2016

Job Description:

Acts as a single point of contact for Underwriting and supports the

regional Actuarial Managers and Directors. Maintains knowledge of new

rules and requirements under the Affordable Care Act and other federal

regulations (such as the Risk Adjustment, Risk Corridor and Reinsurance

(3Rs) and Federal Mental Health Parity), and educates managers and

directors on those new requirements. Maintains and standardizes

existing models and reports, and builds new models and reports to

support Underwriting and regional Actuarial teams to grow profitable

membership (benefit relativity model, actuarial value model, federal

mental health parity model, large group Underwriting rating model, small

group and large rate development model, and Unified Rate Review Template

(URRT) and Medical Loss Ratio (MLR) report). Maintains small and large

group rate development models and standardizes and improves these models

to increase efficiencies and transparencies. Ensures the rate

development model is supported by sound actuarial principles, including

first initial completion of data review and assumptions for the rate

development model and the URRT template. Develops and maintains the

benefit rate relativity model (including new Product Family design) and

supports Underwriting in connection with complicated benefit rate

relativity requests. Serves as liaison between Actuarial and Product

teams for product changes impacting all U.S. states. Maintains the

large group rating model to ensure sound actuarial rating formulas.

Produces standard monthly reports, makes improvements to existing

reports, and develops new reports. Tracks all pricing assumptions,

Affordable Care Act fees and taxes and mandates impacts, rating

requirements, and rules by state. Tests manual rate and factor loads

with sign-off by the regional Actuarial teams. Maintains internal copy

of Actuarial Value Calculator and supports actuarial value calculation

(including minimum value). Supports Federal Mental Health Parity

testing, Mass Credible Coverage, and Federal Credible Coverage.

Develops and maintains new actuarial models such as seasonality factors,

Health Reimbursement Account /Health Savings Account funding loads,

pooling charges, and Alternate Funding Arrangement charges. Recruits,

develops, motivates, assesses, rewards, and coaches staff.

Requirements: Master's degree in Actuarial Science, Business

Administration, Mathematics or related field (willing to accept foreign

education equivalent) plus 3 years of experience performing business

analysis, financial analysis, or risk analysis (including predictive and

mathematical modeling and data analysis and tracking regulations) within

the Health Care industry or a Bachelor's degree and 5 years of

experience as stated above. Also requires: (1) Demonstrated expertise

planning, integrating, and leading cross-functional project teams in the

implementation of strategic projects or initiatives; (2) Demonstrated

expertise performing financial analysis as well as Risk and Predictive

modeling in the Health Care industry and developing and interpreting

models (including those for evaluating and tracking the impact of

Affordable Care Act “3R’s” programs involving Risk Adjustment, Risk

Corridor, and Reinsurance; (3) Demonstrated expertise evaluating and

reporting financial and business impact of state and federal Health Care

mandates on Health Care financial arrangements; and, (4) Demonstrated

expertise analyzing data from the Enterprise Data Warehouse and

optimizing and automating SAS/SQL-based algorithms through User

Acceptance Testing.

Submit resume to christine_asack@harvardpilgrim.org and include job

title and “Job Code GCNC” in the subject line.

Keywords: Harvard Pilgrim Health Care, Boston , Manager, Corporate Actuarial Support, , Wellesley, MA, Massachusetts

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