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Actuarial Consultant / Revenue Forecasting -fastest Growing health Ins

Company: Fallon Community Health Plan
Location: Worcester
Posted on: October 10, 2018

Job Description:



Responsibilities: Major areas of responsibility and accountability:Medicare Advantage bid process

  • Actively participate on corporate bid team
  • Respond to requests from external consultants for data
  • Maintain accurate records of work and develop process documentation
  • Manage CMS/HPMS software
  • Enhance EGWP pricing model and provide account specific rates Product Line support
  • Educate product line management on drivers of variances from budget for all revenue streams
  • Meet regularly with the product line manager to identify and implement reports to improve product performance and identify opportunities to enhance revenue
  • Medical loss ratio reporting for Medicare Advantage, PACE and SCO productsMedicare Supplement product pricing
  • Develop standard pricing for individual and group Med Supp products
  • Provide experience-based rates to large group prospects and renewalsCorporate Project support
  • Participate in corporate projects and subgroup meetings. Complete analyses related to corporate projects and business needs as required.Qualifications: Education:
  • BA or BS - Mathematics, Finance, Economics, Management, other Experience
  • Experience in managed health care financial analysis. Familiarity with Medicare Advantage and/or Part D preferred.
  • Support role: Actuarial, Finance, Accounting, Regulatory, Enrollment, Claims - other
  • Advanced Excel skills
  • SQL- Navigator and/or SAS experience
  • Ability to create presentations & exhibits in formats that meet various audience level
  • 10 years - Managed Care setting
  • 8 years - Excel
  • 5 years - SQL/SAS ExperienceAbility to communicate effectively and in a professional manner in both written and verbal form.PM16 0

    Keywords: Fallon Community Health Plan, Worcester , Actuarial Consultant / Revenue Forecasting -fastest Growing health Ins, Healthcare , Worcester, Massachusetts

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