Position Description

Actuarial Analyst
Location Philadelphia, PA
Primary Job Function Finance
ID** 21693
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Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com.

This role is eligible for a $5,000 sign-on bonus for external candidates

Responsibilities:

Develop health care cost trend analytics as part of a dynamic team.  Build, deploy and maintain dashboards and analyses that support identification of meaningful medical and pharmacy cost trends.  Collaborate with subject matter experts to identify root causes of trends.  Work with markets and corporate functions to identify potential medical cost containment initiatives to manage MLR and develop tracking tools to identify realized vs expected savings targets.  Develop provider contracting tools and methodologies to support network teams – familiarity with value based contracts, risk sharing arrangements, traditional per case and per diem contract development preferred.  Provides support to negotiations on reimbursement rates and provides data to support rate changes/adjustments in various markets.  May work with multiple business segments and departments. The ideal candidate will have a thirst for continuous learning, investigative analytics, reporting, analysis and creative problem solving. He/she will be sought out as an expert on the projects they support, sharing work with a wide array of audiences. This is a great opportunity to utilize strong skills in programming, analytics and reporting.

Education/ Experience: 

  • Bachelor’s Degree business, finance, economics or related quantitative field.  
  • Strong knowledge of personal computer, spreadsheet, and database applications used for analysis.
  • Advanced capabilities with Microsoft Excel including Power Pivot and Power Query; Proficiency with Microsoft PowerPoint.
  • Programming experience in Python & R a plus.
  • Preferred ASA Credentials.
  • 3+ years working within a managed care organization, health insurer, or as a consultant.
  • 3-5 Years claims analysis or cost reporting experience.
  • 3-5 years working in/from a data warehouse environment.
  • 3-5 years of SAS or SQL programming experience.

Other Skills:

  • Problem solving skills, including the ability to work independently and systematically analyze complex problems, draw relevant conclusions, and successfully devise/implement solutions calmly and effectively.
  • Experience mining large data sets.
  • Advanced capabilities with Microsoft Excel; proficiency with Microsoft PowerPoint.
  • Established ability to manage multiple initiatives, shifting back and forth effectively among activities, to produce positive results in a dynamic environment.
  • Excellent written and verbal communication skills.
  • Strong data presentation skills.
  • Solid understanding of relational database fundamentals.
     

 

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