Job description
We offer remote work opportunities (AK, AZ, HI, ID, NV, NM, OR, TX, UT, VA, WA and WY only).
Responsible for providing financial reporting of health care costs to Finance team. Calculates and forecasts key parameters in health insurance. Constructs information tables based on analysis of statistical data and other pertinent information in support of financial forecasting to estimate liabilities.
**Veterans, Reservists, Guardsmen, and military family members are encouraged to apply**
Education & Experience
Required
- Bachelor's degree in Actuarial Science, Mathematics, Statistics or related field, or related equivalent experience
- 3+ years of actuarial experience
- Society of Actuaries certification
- Strong data analysis, statistics, problem solving and project management experience
- Strong knowledge of CPT, DRG, HCPCS, ICD-9, ICD-10 codes and reimbursement
- Knowledge of healthcare claims processing experience
- Advanced in MS Excel and proficient in MS Office Suite
Preferred
- Health care or insurance industry experience
- Knowledge of SQL and data visualization software (e.g. Tableau, PowerBI)
Key Responsibilities
TriWest Healthcare Actuarial Analyst:
- Provides project leadership regarding Actuarial perspectives and requirements with Data Warehousing and Information Technology projects.
- Works with external actuaries, consultants, and government representatives and other entities dealing with TriWest actuarial data.
- Provides data extraction, manipulation and technical analysis for pricing, reserving, claims cost, and revenue experience studies.
- Compiles, evaluates, and analyzes health care change orders for cost impact.
- Develops monthly IBNR and internal and external management reports and provides interpretative support.
- Provides analysis and recommendations on option year pricing / REA’s / claims.
- Develops and analyzes experience data on medical utilization and provider contracting and discounts.
- Maintains Actuarial Services files and documentation and maintains compliance with TriWest policies and procedures.
- Performs administrative and other duties as assigned.
- Regular and reliable attendance is required.
Competencies
Technical Skills
MS Office Suite and advanced in Excel.
Team-Building / Team Player
Influence the actions and opinions of others in a positive direction and build group commitment.
Organizational Skills
Ability to organize people or tasks, adjust to priorities, learn systems, within time constraints and with available resources; Detail-oriented.
Multi-Tasking / Time Management
Prioritize and manage actions to meet changing deadlines and requirements within a high volume, high stress environment.
Information Management
Ability to manage large amounts of complex information easily, communicate clearly, and draw sound conclusions.
Independent Thinking / Self-Initiative
Critical thinkers with ability to focus on things which matter most to achieving outcomes; Commitment to task to produce outcomes without direction and to find necessary resources.
Coping / Flexibility
Resiliency in adapting to a variety of situations and individuals while maintaining a sense of purpose and mature problem-solving approach is required.
Computer Literacy
Ability to function in a multi-system Microsoft environment using Word, Outlook, TriWest Intranet, the Internet, and department software applications.
Company Overview
Taking Care of Our Nation’s Veterans.
It’s Who We Are. It’s What We Do.
Do you have a passion for serving those who served?
Join the TriWest Healthcare Alliance Team! We’re On a Mission to Serve®!
Our job is to make sure that America’s heroes get connected to health care in the community.
At TriWest Healthcare Alliance, we’ve proudly been on that important mission since 1996. For more information about TriWest, please explore our website at www.triwest.com.
Benefits
More about working at TriWest Healthcare Alliance
We’re more than just a health care company. We’re passionate about serving others! We believe in rewarding loyal, hard-working people who are willing to learn as they grow. TriWest Healthcare Alliance values teamwork. Join our team, fulfill your responsibilities, and you may also be considered for frequent pay raises, overtime opportunities to earn even more, recognition and reward programs, and much more. Of course, we also offer a comprehensive and progressive compensation and benefits package that includes:
- Medical, dental and vision coverage
- Generous paid time off
- 401(k) Retirement Savings Plan (with matching)
- Short-term and long-term disability, basic life, and accidental death and dismemberment insurance
- Education Reimbursement
- Paid Volunteer Time
Equal Employment Opportunity
TriWest Healthcare Alliance is an equal employment opportunity employer. All qualified applicants are considered for employment, without discrimination on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, or any other characteristic made unlawful by applicable federal, state, or local laws.
Are you ready to make a difference in the lives of our nation’s heroes?
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