WellSense Health Plan
Actuarial Analyst I/II – WellSense Health Plan
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Job Summary The Actuarial Analyst I/II is a key member of the Finance/Actuarial Services team. Under direct guidance and supervision, the Analytical applies knowledge of mathematics, probability, statistics, and principles of business in order to provide assistance and technical support for rating/pricing, reserving, medical economics, financial forecasting, and healthcare data analytics. The Analyst works with a team of actuaries to assist with the actuarial components of health programs and provides actuarial support to Finance and/or other departments.
Our Investment In You
Full‑time remote work
Competitive salaries
Excellent benefits
Key Functions / Responsibilities
Analyzes financial, statistical and mathematical data and performs actuarial calculations
Develops premium rates through analyses of benefit design, rating factors, claims experience, regulatory mandates, admin expense allocation, and projection of future claim cost
Prepares regulatory rate filings, and data or response for additional inquiries
Develops monthly IBNR reserve estimates for different line of business
Prepares monthly accruals and contract settlements for different line of business
Assists in financial budget, reforecast and other financial projections
Assists in risk adjustment analyses and risk score simulations
Supports trend development, trend drivers study, and/or provider contract analytics
Maintains established reports for internal needs and/or regulatory requirements
Participates in internal and external audits
Provides analytic support for corporate initiatives/projects
Executes SQL/SAS queries and programs to extract data from data warehouse, and reviews the data to ensure accuracy and validity
Summarizes findings and recommendations, and documents the process
Shares knowledge and provides training to new employees
Is a participant in good standing in the Actuarial Student Program, and is committed to completing the Society of Actuaries education courses to attain the ASA or FSA designation
Qualifications Education
Bachelor’s Degree in Mathematics, Actuarial Science, Finance, Economics or related fields
Experience
At least 2 years of progressively responsible experience in actuarial analysis, data modeling, informatics and analysis
Commensurate educational experience in related field will be considered
Successful completion of at least 3 or more SOA actuarial exams, preferred
A background in managed healthcare, insurance operations, preferred
Competencies, Skills, and Attributes
Experienced in MS Office products, SQL, and SAS or other statistical software
Proficient in Excel
Ability to meet deadlines, multi‑task, problem solve and use appropriate technology to analyze business problems
Ability to work collaboratively with team members and other departments
Good communication skills
About WellSense WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high‑quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members.
Equal Employment Opportunity Statement Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability, or protected veteran status. WellSense participates in the E‑Verify program to electronically verify the employment eligibility of newly hired employees.
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Job Summary The Actuarial Analyst I/II is a key member of the Finance/Actuarial Services team. Under direct guidance and supervision, the Analytical applies knowledge of mathematics, probability, statistics, and principles of business in order to provide assistance and technical support for rating/pricing, reserving, medical economics, financial forecasting, and healthcare data analytics. The Analyst works with a team of actuaries to assist with the actuarial components of health programs and provides actuarial support to Finance and/or other departments.
Our Investment In You
Full‑time remote work
Competitive salaries
Excellent benefits
Key Functions / Responsibilities
Analyzes financial, statistical and mathematical data and performs actuarial calculations
Develops premium rates through analyses of benefit design, rating factors, claims experience, regulatory mandates, admin expense allocation, and projection of future claim cost
Prepares regulatory rate filings, and data or response for additional inquiries
Develops monthly IBNR reserve estimates for different line of business
Prepares monthly accruals and contract settlements for different line of business
Assists in financial budget, reforecast and other financial projections
Assists in risk adjustment analyses and risk score simulations
Supports trend development, trend drivers study, and/or provider contract analytics
Maintains established reports for internal needs and/or regulatory requirements
Participates in internal and external audits
Provides analytic support for corporate initiatives/projects
Executes SQL/SAS queries and programs to extract data from data warehouse, and reviews the data to ensure accuracy and validity
Summarizes findings and recommendations, and documents the process
Shares knowledge and provides training to new employees
Is a participant in good standing in the Actuarial Student Program, and is committed to completing the Society of Actuaries education courses to attain the ASA or FSA designation
Qualifications Education
Bachelor’s Degree in Mathematics, Actuarial Science, Finance, Economics or related fields
Experience
At least 2 years of progressively responsible experience in actuarial analysis, data modeling, informatics and analysis
Commensurate educational experience in related field will be considered
Successful completion of at least 3 or more SOA actuarial exams, preferred
A background in managed healthcare, insurance operations, preferred
Competencies, Skills, and Attributes
Experienced in MS Office products, SQL, and SAS or other statistical software
Proficient in Excel
Ability to meet deadlines, multi‑task, problem solve and use appropriate technology to analyze business problems
Ability to work collaboratively with team members and other departments
Good communication skills
About WellSense WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high‑quality health plans and services that work for our members, no matter their circumstances. WellSense is committed to the diversity and inclusion of staff and their members.
Equal Employment Opportunity Statement Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability, or protected veteran status. WellSense participates in the E‑Verify program to electronically verify the employment eligibility of newly hired employees.
#J-18808-Ljbffr