Our Mission is to Make Healthcare Right. Together. Built upon the belief that by connecting and aligning the best local resources in healthcare delivery with the financing of care, we can deliver a superior consumer experience, lower costs, and optimized clinical outcomes.
What drives our mission? The company values we live and breathe every day. We keep it simple: Be Brave. Be Brilliant. Be Accountable. Be Inclusive. Be Collaborative.
If you share our passion for changing healthcare so all people can live healthy, brighter lives – apply to join our team.
SCOPE OF ROLE
The Actuarial Consultant will have a supporting role to the Valuation Actuary in the reserve setting process for all Line’s of Business for the company, including ACA Individual, Medicare Advantage, commercial small and large group, and excess of loss contracts. The Actuarial Consultant should have prior experience in setting health insurance reserves, and settle into the role of setting the reserves each month to be reviewed by the Valuation actuary.
The following Actuarial Consultant job description is intended to point out major responsibilities within the role, but the role is not limited to these items:
Coordinate with junior analysts in monthly data preparation, including the gathering and uploading of paid claims, membership, and pended claims information into Company’s reserve model.
Perform reviews of the populated reserve models for each state/market by line of business and develop the preliminary estimates which will be reviewed by the Valuation Actuary.
Coordinate with the Pricing and Finance staff to obtain pricing and G&A expense information to prepare Premium Deficiency Reserve projections
Work in tandem with Valuation Actuary to make adjustment to the preliminary reserve estimates based on a joint review/evaluation process.
Prepare summary reports to be shared with Finance staff and participate on follow up calls to discuss the results during the monthly close calls.
Manage your own project timelines and work of supporting staff, meet all deadlines, and produce high quality deliverables.
Ancillary projects, such as providing completion factors to other analytics teams and performing ad hoc adjustments to the reserving process based on changing expense structures such as introduction of capitation contracts and their assessment on future reserve forecasts.
Mentor junior members of the team’s staff. Foster a culture of peer review, mentorship, and learning.
This position will have supervisory responsibilities as the team grows
EDUCATION, TRAINING, AND PROFESSIONAL EXPERIENCE
A Bachelor’s degree required in Math, Statistics, Economics, Actuarial Science, or a related field is required
Four (4) or more years of experience in setting health insurance reserves is required.
Associate of the Society of Actuaries or greater required
Understanding of healthcare claims data
Prior experience managing others is preferred but not required
Proficient in Microsoft Excel and other Office products
Experience with forecasting, modeling, and SQL
Expert level knowledge of healthcare reserving.
Self-starter with ability to manage projects with little to no direction. Sense of ownership and responsibility is required
Strong communication skills and ability to meet with C-Suite leadership on reserving and plan related topics
LICENSURES AND CERTIFICATIONS
Associateship or greater in the Society of Actuaries or commensurate year of experience
The majority of work responsibilities are performed in an open office setting, carrying out detailed work sitting at a desk/table and working on the computer.
Some travel may be required.
We’re Making Healthcare Right. Together.
We are realizing a completely different healthcare experience where payors, providers, doctors, and patients can all feel connected, aligned and unified on the same team. By eradicating the frictions of competing needs, we are making it possible to give everyone more of what they want and deserve. We do this by:
Focusing on Consumers We understand patient pain points, eliminating complexity while increasing transparency, for greater access and easier navigation.
Building on Alignment We integrate and align individual incentives at all levels, from financing to optimization to delivery of care.
Powered by Technology
We employ our purpose built, integrated data platform to connect clinical, financial, and social data, to deliver exceptional outcomes.
As an Equal Opportunity Employer, we welcome and employ a diverse employee group committed to meeting the needs of Bright Health, our consumers, and the communities we serve. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law.