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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