Trend & Analytics Consultant Senior (Actuarial Business Consultant)

How You Will Make an Impact

• Identifies, monitors, and analyzes major healthcare trends within an assigned business area, including cost, utilization, clinical, operational, financial, and/or customer-impacting trends.
• Proactively investigates emerging issues, anomalies, and performance changes to determine root causes and quantify business impact.
• Develops clear, actionable insights and recommendations that help customers and business partners understand trends and determine potential next steps.
• Translates complex data and analytics into concise, meaningful narratives for senior leaders, business partners, and non-technical audiences.
• Serves as a senior analytical consultant to assigned business areas by helping frame business questions, identify key drivers, and evaluate potential solutions.
• Designs and completes special projects such as developing and maintaining experience-rating formulae and creating and/or reviewing alternative settlement models and risk sharing models.
• Responsible for recommendations on pricing, marketing, product design, claims, premium and enrollment administration of business unit.
• Responsible for valuation support for business unit by interpreting financial results, variances from forecast to help identify product and segment behavior to assist in the risk management of the business unit.

Minimum Requirement

• BA/BS in Mathematics, Statistics or related field and minimum of 8 years related experience in an actuarial environment performing financial reporting, rate development, evaluation of risk contingencies and/or trend projections; or any combination of education and experience, which would provide an equivalent background.

Primary Duties and Responsibilities

• Healthcare analytics experience.
• Experience with utilization management data strongly preferred.
• Experience with Utilization Management systems and Behavioral Health programs highly desired.
• 4 years of database development and data management.
• Experience with Snowflake.
• Strong experience in MS SQL Server (2016 or newer).
• Proficiency in reporting and visualization tools (Tableau, Power BI, SSRS).
• Advanced SQL skills, including writing complex queries and stored procedures.
• Strong Excel and general data analysis skills.
• Excellent communication skills, project management/implementation, interpersonal and organizational skills.
• Demonstrated curiosity, initiative, and a strong desire to learn.

Pay

The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the Company. The Company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

Requirements

Requires a BA/BS in Mathematics, Statistics or related field and minimum of 8 years related experience in an actuarial environment performing financial reporting, rate development, evaluation of risk contingencies and/or trend projections; or any combination of education and experience, which would provide an equivalent background.