Lead Analyst, Pricing

Employment Type

Full-time

Exempt

Pay Range: $78,000 - $153,000

Note:

Individuals typically begin between the minimum to middle of the pay range.
The Lead Actuarial Analyst contributes towards HMSA's financial stability by providing leadership, expertise and support for the company's various actuarial functions, as assigned. These might include trend analysis and projections, pricing, financial forecasting/reporting and rates filing.

• Bachelor's degree and passed three actuarial exams with four years of relevant work experience
• Working knowledge of actuarial and underwriting concepts.
• Effective written and verbal communication skills.
• Strong mathematical, analytical and problem-solving skills
• Proficient working knowledge of Microsoft Office Word, Outlook, and PowerPoint.
• Advanced knowledge of Microsoft Excel.

• Lead the pricing and rating of HMSA's products, including the following:
  • Collecting and analyzing historical experience data, developing projections and modeling financial outcomes under various rating scenarios.
  • Regularly updating the rating methodology and factors for HMSA's ACA Individual and Small Group lines of business, including pricing model updates, Risk Adjustment payment analysis and associated rate filings documents preparation.
  • Supporting the development of annual Medicare bid submissions and group retiree pricing, including pricing soundness check on gain/loss), risk score and payment, advising on process improvement etc.
  • Support QUEST program including capitation rate impact analysis, regulatory compliance and data integrity & encounter analysis.
  • Configuring and testing rate tables and factors in HMSA's systems.
• Lead complex trend analysis and projections, including:
  • Monitoring emerging experience monthly, reconciling this against other sources and comparing against budget/forecast.
  • Analyzing significant utilization, unit cost and other trend drivers, as well as variances against budget/forecast.
  • Based on emerging trends, known/projected provider contract and other key drivers, lead the development of trend forecasts to be used for financial projection and rating purposes.
• Produce ad-hoc financial & statistical analyses, data pulls or studies, as needed.
• Assist the annual budget and reforecast of various LOBs. Other financial reporting duties, as assigned.
• Lead the creation of revenue and expense projections at the line of business level. Monitor emerging experience against these projections and produce variance analyses on a regular basis.
• Performs all other miscellaneous responsibilities and duties as assigned or directed.