Aetna Sr. Actuarial Consultant - 62486BR in Phoenix, Arizona
Req ID: 62486BR
Support actuarial functions by applying quantitative skills and analytical methods. Take full ownership of assigned projects and potentially act as project team lead. Leverage more advanced technical skills to achieve business solutions and demonstrate solid understanding of business and product processes.
Fundamental Components included but are not limited to:
• Aetna Way - Exhibit behavior that reflects Aetna s values and is in accordance with the Aetna Way.
• Leadership: - Serve as a team lead for various Medicaid markets in the Western region. Act as mentor to newer or less experienced staff. Facilitate training and development opportunities.
• Regulatory Issues - Demonstrate understanding of regulatory compliance issues. Assist in the state reporting process with reserve allocations and quarterly Schedule H analysis for Western Medicaid markets.
• Risk Analysis & Management - Work with Medicaid plan leadership and supervisor to understand the nature of specific risks. Share results of analysis with management.
• Rate Impact Analysis and Pricing Models - Analyze rate offers by various states to Aetna's PMPM cost and mix. Prepare and submit necessary exhibits for regulatory filings.
• Reserve Liability Setting - Analyze claim data and monitor reserve levels for appropriateness. Demonstrate understanding of actuarial reserving techniques and issues.
• Planning & Forecasting - Populate and update Q1, Q2, and Q3 forecasts. Make recommendations to supervisor regarding trends, unit cost and utilization changes due to future benefit changes/network changes.
• Communication, Collaboration & Verbal/Written Communication- Respond to inquiries from Finance/Plan Leadership/Valuation/BIS/Medicaid Actuarial team regarding claims impacts of changes in Medicaid contracts. Create and maintain accurate documentation and develop training materials for tools and processes.
Qualifications Requirements and Preferences:
• Bachelor s degree along with 3 - 4 years of experience in Health insurance
• Must have passed a minimum of 4 actuarial exams and pursuing an ASA (Associate of the Society of Actuaries) credential.
• Technical Proficiency: - High proficiency with SQL and EXCEL.
• 2 - 3 years of Managed Care Medicaid experience preferred.
• This position requires commuting to the Aetna Medicaid office in Phoenix, Arizona.
General Business - Applying Reasoned Judgment
Finance - Delivering Profit and Performance
Benefit eligibility may vary by position. Click here to review the benefits associated with this position.
Job Function: Actuarial
Aetna is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected Veterans status.