Independence Blue Cross - Philadelphia, PA
posted about 1 month ago
The Actuarial Analyst II position at Independence is a critical role that involves performing semi-routine actuarial and statistical analyses to estimate financial outcomes. This position requires a strong foundation in mathematics, probability, statistics, and business principles to effectively complete health calculations. The duties of the Actuarial Analyst II will vary depending on the specific unit they are assigned to, which may include Pricing, Medical Cost Analysis, or Reserving/Planning. In the Pricing unit, the analyst will prepare data for pricing research, which includes conducting experience and trend analyses, performing book of business studies, and analyzing CMS revenue and risk scores. They will also be responsible for preparing rating information packages for underwriting and other internal customers, as well as rate filings for State Insurance Departments and CMS. Additionally, the analyst will gather necessary information for special projects, such as demographic factors and competitive analysis, and perform other duties as required. For the Medical Cost Analysis unit, the analyst will prepare analyses and monitor claims trends across various lines of business. This includes segregating costs, utilization, mix of services, and the effects of benefit and demographic changes. The analyst will prepare reports on medical cost results, both historical and projected, and support the valuation of medical cost initiatives while tracking performance against established goals. They will also assist in developing trend projections and undertake other special projects as needed. In the Reserving/Planning unit, the analyst will develop, calculate, and monitor accruals, liabilities, and reserves for assigned lines of business. They will work closely with actuaries or management to ensure that proper formulae are developed and applied. The analyst will also develop interim estimates of refund liabilities for large accounts and coordinate with Finance and Rating/Underwriting departments to ensure accurate projections and accruals. Furthermore, they will compile data to support monthly financial forecasts of premium and claims and may assist in preparing the actuarial portions of financial statements and federal income tax returns. Other duties and special projects may also be assigned as required.