Jobs
>
Boston

    Manager of Actuarial Services - Boston, United States - BMC HealthNet Plan

    BMC HealthNet Plan
    BMC HealthNet Plan Boston, United States

    2 weeks ago

    Default job background
    Full time
    Description
    Job Description

    It's an exciting time to join the WellSense Health Plan, a growing regional health insurance company with a 25-year history of providing health insurance that works for our members, no matter their circumstances.

    The Actuarial Manager is a key member of the Finance / Actuarial Services team. As a team leader and a Subject Matter Expert, the Actuarial Manager leads or oversees actuarial functions for pricing, reserving, medical economics, financial forecasting, and/or healthcare data analytics. The Actuarial Manager collaborates with Finance teams or other departments in the organization to oversee and assure a coordinated approach to the actuarial components of health programs and provides actuarial expertise to protect the organization's financial integrity.

    Our Investment in You:
    • Full-time remote work
    • Competitive salaries
    • Excellent benefits
    Key Functions/Responsibilities:
    • Leads the rate development process by providing analyses and recommendations on benefit design, rating factors, trend picks, and projection of future claim cost.
    • Oversees regulatory rate filings and prepares data or response for additional inquiries.
    • Leads the development of monthly IBNR reserve estimates for different line of business.
    • Oversees monthly accruals and contract settlements for different line of business.
    • Leads financial budget, reforecast and other financial projections.
    • Evaluates and makes recommendations regarding the adequacy of capitation rates from state Medicaid programs or other new program.
    • Coordinates with various departments and cross-functional teams to capture, value, and scorecard medical cost savings initiatives.
    • Leads risk adjustment analyses and risk score simulations.
    • Leads trend development, trend drivers' study, and/or provider contract analytics.
    • Maintains financial relationships with vendors and providers. Represents Finance in negotiations of financial terms to support network contracting strategy or outsourcing strategy.
    • Develops analytic reports for internal needs and/or regulatory requirements.
    • Initiates and leads efforts to improve quality and efficiency of actuarial models, analyses and reports.
    • Summarizes findings and makes recommendations.
    • Develops presentations and communicates to senior management or external parties.
    • Leads response to internal and external audits.
    • Serves as actuarial representative or SME for corporate initiatives/projects.
    • Advises Finance department on data warehouse designs, requests and works with IT to implement or improve business processes.
    • Drives organizational talent by retaining and developing colleagues and/or actuarial students.
    Qualifications:

    Education:
    • Bachelor's Degree in Mathematics, Actuarial Science, Finance, Economics or related fields.
    Experience:
    • More than 5 years of progressively responsible experience in actuarial analysis, data modeling, informatics and analysis.
    Preferred/Desirable:
    • A background in managed healthcare, insurance operations.
    • 2+ years of prior experience managing a small team of analysts.
    • Master's degree.
    • ASA or FSA
    Competencies, Skills, and Attributes:
    • Proficient in Excel, SQL, and SAS or other statistical software.
    • Strong interpersonal skills to lead and direct the efforts of others, both internally and externally.
    • Strong analysis skills. Must be able to conceptualize and envision the impact of change, and propose new ways to do business.
    • Ability to meet deadlines, multi-task, problem solve and use appropriate technology to analyze business problems. Project management skills a plus.
    • Strong communications skills, both verbal and written.
    About WellSense

    WellSense Health Plan is a nonprofit health insurance company serving more than 740,000 members across Massachusetts and New Hampshire through Medicare, Individual and Family, and Medicaid plans. Founded in 1997, WellSense provides high-quality health plans and services that work for our members, no matter their circumstances.
  • Alera Group

    Summer Intern Employee Benefits

    4 days ago

    Alera Group BOSTON, United States

    Position Overview: · Spring Consulting Group, LLC, an Alera Company, is looking for summer interns to join our growing team. As a summer intern, you will work within a team to develop solutions for clients offering employee health, life, disability and pension benefits. This pos ...

  • Abacus Insights

    Client Solutions Manager – Finance

    2 weeks ago

    Abacus Insights Boston, United States Full time

    Abacus Insights is a mission-driven technology company focused on transforming the healthcare data industry, ultimately creating a more personalized patient experience, improving health outcomes, and lowering the overall cost of healthcare. Abacus Insights provides a flexible, ef ...

  • Fidelity Investments

    Consultant, Health

    3 weeks ago

    Fidelity Investments Boston, United States Full time

    Job Description: · The Team · Our health and welfare consulting team at Fidelity provides a unique experience for candidates looking for an opportunity to grow their consulting career. Our value proposition to associates is centered on three important qualities: · 1) We are passi ...

  • Berkshire Hathaway Specialty Insurance

    Program Manager, Commercial Flood

    3 weeks ago

    Berkshire Hathaway Specialty Insurance Boston, United States Full time

    Who are we? · A strategic and trusted insurance partner, Berkshire Hathaway Specialty Insurance (BHSI), provides a broad range of commercial property, casualty and specialty insurance coverages and outstanding service to customers and brokers around the world. Part of Berkshire H ...

  • Kalos Consulting, Inc.

    Health and Benefits Actuarial Consultant

    2 weeks ago

    Kalos Consulting, Inc. Boston, MA, United States

    Job Description · Job Description · Company Highlights · Our client is a leading global advisory, broking and solutions company that helps clients turn risk into growth. · They are firm built on a long history of serving their clients with excellence to design and deliver sol ...

  • Alera Group

    Summer Interns Needed

    4 days ago

    Alera Group Boston, MA, United States

    Spring Consulting Group, LLC, an Alera Company, is looking for summer interns to join our growing team. As a summer intern, you will work within a team to develop solutions for clients offering employee health, life, disability and pension benefits. This position will based in ou ...

  • Plymouth Rock Assurance

    Claims Supervisor, Bodily Injury

    1 week ago

    Plymouth Rock Assurance Boston, United States

    Are you a dynamic leader with extensive experience in casualty claims management? We're seeking a Bodily Injury Claims Manager to oversee a dedicated team of Claims Representatives in our vibrant downtown Boston office. In this role, you will be responsible for driving the profes ...

  • Liberty Information Technology Limited

    Sourcing - Senior Underwriting Officer - Construction

    5 days ago

    Liberty Information Technology Limited Boston, United States Full time

    Pay Philosophy · The typical starting salary range for this role is determined by a number of factors including skills, experience, education, certifications and location. The full salary range for this role reflects the competitive labor market value for all employees in these p ...

  • BERKSHIRE HATHAWAY SPEC INS

    Claim Executive

    2 weeks ago

    BERKSHIRE HATHAWAY SPEC INS Boston, MA, United States

    A strong, trusted insurance partner, Berkshire Hathaway Specialty Insurance (BHSI) provides a broad range of commercial property, casualty and specialty insurance coverages and outstanding service to customers around the globe. Part of Berkshire Hathaway's insurance operations, w ...

  • Massachusetts Health Policy Commission

    Senior Associate, Market Oversight and Transparency

    1 week ago

    Massachusetts Health Policy Commission Boston, United States

    Posted on November 17, 2023 · The seeks a Senior Associate to review and analyze changes to the health care marketplace, including provider mergers and acquisitions. This is a terrific opportunity for a motivated individual with dedication to public service to help lead the groun ...

  • Berkshire Hathaway Specialty Insurance

    Senior Claims Examiner

    1 week ago

    Berkshire Hathaway Specialty Insurance Boston, United States

    Job Description · Job DescriptionWho are we? · A strategic and trusted insurance partner, Berkshire Hathaway Specialty Insurance (BHSI), provides a broad range of commercial property, casualty and specialty insurance coverages and outstanding service to customers and brokers aro ...

  • Blue Cross Blue Shield of Massachusetts

    Associate Director, Group Medicare Sales

    3 weeks ago

    Blue Cross Blue Shield of Massachusetts Boston, United States Full time

    Reporting to the SVP, Sales & Client Management, the Director, Group Medicare Sales, is an integral member of the leadership team—driving BCBSMA's purposeful re-entry into the Group Medicare Advantage Market. · The role will have responsibility for Group Medicare Advantage and M ...

  • Corvus Insurance

    Senior Product Manager

    2 weeks ago

    Corvus Insurance Boston, MA, United States

    We're united by a mission: to make the world a safer place. Corvus Insurance uses novel data and artificial intelligence/machine learning to achieve better insights into commercial insurance risk. Our software empowers brokers and policyholders to better predict and prevent compl ...

  • Veolia North America

    Retirement & Financial Benefits Program Manager

    1 week ago

    Veolia North America Boston, MA, United States

    About Veolia North America · A subsidiary of Veolia Group, Veolia North America (VNA) offers a full spectrum of water, waste and energy management services, including water and wastewater treatment, commercial and hazardous waste collection and disposal, energy consulting and re ...

  • Liberty Mutual

    Senior Underwriter, Shared

    2 weeks ago

    Liberty Mutual Boston, MA, United States

    The full salary range for this role reflects the competitive labor market value for all employees in these positions across the national market and provides an opportunity to progress as employees grow and develop within the role. Description Our Senior Underwriter contributes to ...

  • Massachusetts Mutual Life Insurance Company (MassMutual)

    Actuarial Community Program Manager, Corporate Actuarial and Business Analytics

    2 days ago

    Massachusetts Mutual Life Insurance Company (MassMutual) Boston, United States Full time

    Actuarial Community Program Manager · Corporate Actuarial and Business Analytics · Full-Time · Boston, MA or Springfield, MA (Hybrid) · The Opportunity · As the MassMutual Actuarial Community Program Manager, you will lead the evolution, transformation, and execution of Actuarial ...

  • Chubb

    Medical Underwriter I

    2 weeks ago

    Chubb Boston, MA, United States

    Chubb is the world's largest publicly traded property and casualty insurer. With operations in 54 countries, Chubb provides commercial and personal property and casualty insurance, personal accident and supplemental health insurance, reinsurance and life insurance to a diverse gr ...

  • Gradient AI

    VP Health Insurance

    1 week ago

    Gradient AI Boston, MA, United States

    Job Description · Job Description · About Gradient AI: · Gradient AI is a fast-growing startup, bringing state-of-the-art Artificial Intelligence (AI) and Machine Learning (ML) solutions to the trillion-dollar insurance industry. Founded in 2018, we are a well-financed, have r ...

  • Alera Group

    Senior Actuarial Consultant Employee Benefits

    3 weeks ago

    Alera Group Boston, United States

    Spring Consulting Group, LLC, an Alera Company, is looking for aspiring actuaries to join our growing team. As an actuarial analyst, you will work within a team to develop solutions for clients offering employee health, life, disability and pension benefits. This position will ba ...

  • American International Group, Inc.

    Senior Actuarial Analyst

    3 weeks ago

    American International Group, Inc. Boston, United States Full time

    Who we are · American International Group, Inc. (AIG) is a leading global insurance organization. Building on 100 years of experience, today AIG member companies provide a wide range of property casualty insurance, life insurance, retirement solutions, and other financial service ...