Actuarial Solutions Analyst-Perm-120-160K in Nashville at Vaco

Date Posted: 1/20/2020

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Nashville
  • Job Type:
  • Experience:
    5 years
  • Date Posted:
    1/20/2020
  • Job ID:
    ACTUA43475

Job Description

Job Summary:
This role is responsible for performing risk and health analytics that cover a broad range of providers, patients, and payers.
Tasks include, but not limited to working with operations/finance/claims staff to strengthen existing payment integrity initiatives, analyzing utilization and cost data to develop medical cost drivers of the organization, producing monthly reports on utilization and cost, delivering actionable insights from analysis of utilization and cost data on key medical expense drivers vs. budget and YOY trend.

In addition, the responsibilities also include working with authorization data to provide regular compliance and operational reporting, developing advanced analytics use cases and delivering actionable insights to all stakeholders across the company.

This candidate must have experience in report development, data sciences/statistical data analysis, and have strong SQL experience to query, maintain, and create reports across SSRS, SSAS, and other SQL related tools.

The ideal candidate is creative, self-sufficient and resourceful.

The candidate must be able to assess existing data model and propose enhancements required to complete risk assessment and clinical and operational reporting.
They must have the ability to quickly learn both the technology and business concepts, and experience in working with both business and IT teams.

DUTIES AND RESPONSIBILITIES:


Demonstrates Competency in the Following Areas:


Solve reporting requests by performing complex data analysis and report development in both tabular and graphic reporting tools for example SSRS, Tableau, Power BI etc.


Perform revenue reconciliation analytics using complex data sets


Perform dynamic health plan pricing analytics with confidence intervals


Incorporate data findings into high level corporate reporting and monitor experience for all lines of business. Provide data quality feedback for upstream source system.


Ability to work with and communicate technical information to multiple levels of technical and non-technical staff including data engineers, operators and clinicians


Review and analyze complex claims data and translate it into meaningful client reporting


Participate in team lunch and learns, design sessions, and pattern/code reviews.


Provide other data analysis related to utilization management, claims adjudication, and other data as required by management. Build sustainable self-serving reporting products.


Job Requirements

  • Bachelor's degree in finance, mathematics, actuarial science, or related field from an accredited institution.
  • Progress toward ASA with 3 or more completed exams preferred.
  • 5+ years of experience in an actuarial role within a health insurance managed care organization preferred.
  • 5+ years' experience using Microsoft SQL Server Management Studio solutions and reporting preferred.
  • Advanced understanding of Relational and Dimensional data structures and use.
  • Experience using cloud-based database platforms preferred.
  • Negotiation and persuasion skills; ability to facilitate consensus among a diverse group of stakeholders.
  • Ability to demonstrate an understanding of data structures and resolve problems.
  • Strong listening skills; ability to capture requirements expressed in design meetings.
  • Flexible and adaptable regarding learning and understanding new technologies.
  • Highly self-motivated and directed.
  • Experience with Agile development (SAFE or other).

Skills

  • Advanced Excel skills - create pivot tables, v-lookups, and spreadsheets with formulas.
  • Advanced SQL programming/coding required.
  • Intermediate R/RStudio experience preferred.
  • Intermediate Python experience preferred.
  • Excellent analytical and problem-solving skills.
  • Ability to translate complex data into insights.
  • Excellent verbal and written communication skills.
  • Experience with BI tools such as Microsoft Power BI or Tableau.
  • Mentors team members in technology, architecture and delivery of applications.
  • Successful teamwork experience and demonstrated leadership abilities are required.
  • Creates a shared sense of direction and community among the teams.
  • Time management skills are a must; as well as the ability to be flexible and creative. Ability to work with evolving requirements and analysis needs.
  • Possesses the cultural attributes of the organization and understands how to work in a small fast paced environment.
  • Knowledge of database architecture and design. This includes relational SQL databases, PostgreSOL and other relational, operational and cloud databases.
  • Ability to interpret written requirements and technical specification documents and design and implement solutions based on requirement specifications.
  • Ability to code software according to published standards and design guidelines. Adherence to myNEXUS software development standards is critical.

Educational Requirements:

  • Bachelor's degree in finance, mathematics, actuarial science, or related field from an accredited institution.
  • Progress toward ASA with 3 or more completed exams preferred
    .