Note: The job is a remote job and is open to candidates in USA. SCAN is a nonprofit health organization focused on improving care for older adults through Medicare Advantage, integrated care, and innovative care delivery models. The Senior Actuarial Analyst prepares and analyzes data for provider contract modeling, supports network negotiations and Medicare Advantage bid development, and improves actuarial workflows and model efficiency.
Responsibilities
- Use tools that currently exist support provider contract negotiations for globally capitated and shared risk providers. Support to include financial modeling, DOFR valuations (internal claims extraction / analysis and external research), health care cost trend, risk analysis, and advice / guidance to the Network Management and Contracting teams
- Develop ad hoc provider claims modeling and analysis for fee-for-service provider negotiations. Financial analyses may incorporate Medicare fee schedules and potentially repricing
- Support ad-hoc analytics such as product development, and other customized projects to suit business needs. Utilize the Data Warehouse efficiently to develop reports and extract data fields
- Assist the actuarial team with the development of Medicare Advantage bid by keeping track of network assumptions and scenarios
- Proactively identify opportunities to streamline workflows, enhance model efficiency, and improve automation of existing processes
- Bring intellectual curiosity and a continuous improvement mindset to all assigned work, challenging the status quo where appropriate
- We seek Rebels who are curious about AI and its power to transform how we operate and serve our members
- Actively support the achievement of SCAN’s Vision and Goals
- Other duties as assigned
Skills
- Bachelor's Degree in Actuarial Science, Mathematics, or Statistics or any other major with significant quantitative course work is required
- 3+ years of healthcare actuarial, healthcare economic, or healthcare finance experience; or comparable consulting experiences
- Experience with provider contract modeling and Medicare FFS structure
- Certifications deemed to be reasonable to function at this level
- Performs work under general supervision. Handles moderately complex issues and problems, and refers more complex issues to higher-level staff. Possesses solid working knowledge of subject matter. May provide leadership, coaching, and/or mentoring to a subordinate group
- Advanced Analytical Skills: Proficient in using statistical and mathematical models to analyze complex data sets, identify trends, and make informed predictions
- Technical Proficiency: Expertise in actuarial software and tools such as Excel, SQL, and specialized actuarial modeling software
- Communication and Collaboration: Strong ability to communicate technical information clearly to non-technical stakeholders and work effectively in cross-functional teams
- Microsoft Office Suite (Word, Excel including formulas, V-Lookups, and pivot tables, PowerPoint, Access, Outlook, Teams), and SQL at advance level is required
Benefits
- An annual employee bonus program
- Robust Wellness Program
- Generous paid-time-off (PTO)
- Eleven paid holidays per year, plus 1 floating holiday, plus 1 birthday holiday
- Excellent 401(k) Retirement Saving Plan with employer match and contribution
- Robust employee recognition program
- Tuition reimbursement
- Mostly Remote
- An opportunity to become part of a team that makes a difference to our members and our community every day!
Company Overview