Actuarial Analyst
Current• Assist in monthly IBNR reserving process for Medicaid, Medicare, and Commercial lines by assessing paid triangles, market trends, special payment projects, and administrative rulings• Collaborate in annual commercial ACA rate filing process for both individual and small group, update and enhance existing pricing model, evaluate current claim cost and utilization trends, and prepare rate filing documents• Coordinate with Underwriting and Sales Department in providing quotes for benefit design changes using benefit pricing model, remodeling automatic process for commercial renewals using excel and macro, and constructing data tables for financial reports using SAS and SQL• Construct financial reports for value-based programs, evaluate providers’ performance, structure models for payout calculation financial, and contribute in HSD reporting deliverables• Conduct ad-hoc analysis on commercial populations to help senior leadership with strategic decision-making, including the morbidity of the population, and utilization pattern of certain services• Redesign and document the process for determining commercial plans’ MA PD creditability• Partner with Analysis Organization in data warehouse maintenance and enhancement, identify, investigate, reconcile, and resolve data issues
