Senior Actuarial Analyst - Carolina, United States - Brighton Health Plan Solutions, LLC

Brighton Health Plan Solutions, LLC Carolina, United States

2 weeks ago

Description

Job Description

Job Description
About The Role

The Senior Actuarial Analyst – Network will be an enthusiastic team player, providing actuarial and analytical support to Network Management and Contracting.

This role will be deeply involved in the analytical processes that drive executive business decisions related to the Brighton Health Plan Solutions provider network and health plan management services.

As Senior Actuarial Analyst – Network, you will be challenged to think creatively and develop data-driven solutions to complex problems facing the healthcare industry.

This role will report to the Manager & Lead Actuary.

Primary Responsibilities

Collaborate with Network Management and Contracting to provide ongoing analytical support
Develop and maintain forecasting models, and analytical reports and dashboards
Develop actionable data insights that inform network strategy
Support financial and actuarial components of product and network development, including evaluation of new products
Conduct analysis specific to the medical economics underlying provider financial arrangements in support of new business, client and provider retention efforts
Provide financial analysis for more complex and/or larger health plan clients, such as alternative provider network configurations
Perform medical cost trend analysis and identify cost savings opportunities
Evaluate provider networks based on available benchmarks and published data sources

Essential Qualifications

Bachelor's Degree in Actuarial Science, Mathematics, Statistics, Finance, Computer Science, Information Systems, Data Science, Analytics, Engineering, Economic Sciences or related field
4-6 years of experience in an actuarial or analytical capacity at a health plan or consulting firm required, preferably in a managed care setting
3+ Society of Actuaries (SOA) exams successfully completed
Proficiency in SQL and Microsoft SQL Server Suite of Products (SSMS) required
Proficiency in MS Excel required
Experience with Business Intelligence applications and DAX functions (PowerPivot, Power BI, Tableau) a plus
Experience with evaluating carrier rates using external sources (i.e. MRFs) a plus
Experience with alternative payment models (i.e. value-based payment models, bundled payment arrangements) a plus
Excellent quantitative and problem-solving skills
Excellent oral and written communications skills
Ability to exercise professional judgement independently
Ability to explain technical concepts to a non-technical audience
Ability to effectively manage and prioritize several concurrent projects

About

At Brighton Health Plan Solutions, LLC, our people are committed to the improvement of how healthcare is accessed and delivered.

When you join our team, you'll become part of a diverse and welcoming culture focused on encouragement, respect and increasing diversity, inclusion, and a sense of belonging at every level.

Here, you'll be encouraged to bring your authentic self to work with all your unique abilities.

Brighton Health Plan Solutions partners with self-insured employers, Taft-Hartley Trusts, health systems, providers as well as other TPAs, and enables them to solve the problems facing today's healthcare with our flexible and cutting-edge third-party administration services.

Our unique perspective stems from decades of health plan management expertise, our proprietary provider networks, and innovative technology platform.

As a healthcare enablement company, we unlock opportunities that provide clients with the customizable tools they need to enhance the member experience, improve health outcomes, and achieve their healthcare goals and objectives.

Together with our trusted partners, we are transforming the health plan experience with the promise of turning today's challenges into tomorrow's solutions.

Come be a part of the Brightest Ideas in HealthcareTM.

Company Mission

Transform the health plan experience – how health care is accessed and delivered – by bringing outstanding products and services to our partners.

Company Vision
Redefine health care quality and value by aligning the incentives of our partners in powerful and unique ways.

DEI Purpose Statement
At BHPS, we encourage all team members to bring your authentic selves to work with all your unique abilities.

We respect how you experience the world and welcome you to bring the fullness of your lived experience into the workplace.

We are building, nurturing, and embracing a culture focused on increasing diversity, inclusion and a sense of belonging at every level.

*We are an Equal Opportunity Employer
*Open to fully remote candidates

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