Actuarial Analyst III, Value-Based Contract Analytics (Remote)

Purpose:
Shape the world of health care by joining UPMC! As a leader in the industry, we are committed to enhancing the lives of all who are a part of our community. Without our employees, we would not be able to innovate health care for our patients and health plan members. From hospitals to our corporate office, all UPMC employees impact our mission of creating life-changing medicine. To continue our tradition of excellence, we are in search of full-time Actuarial Analyst III to join this community as well. 

The Department of Health Economics is seeking an Actuarial Analyst III. This experienced healthcare actuarial analyst would help drive high-visibility impactful analysis supporting medical cost improvement strategies for UPMC Health Plan. This includes analyzing medical cost utilization and unit cost data, identifying top trend drivers and affordability opportunities, developing and evaluating financial outcomes of value-based programs and presenting findings to leadership. This position may also direct or supervise less experienced actuarial students in the performance of duties.

The Actuarial Analyst III will require a diverse set of skills, including strong communication skills, sharp critical thinking abilities, and a curiosity for health economics and data analytics.

As an Actuarial Analyst III at UPMC, you will be given support to reach professional designations through our comprehensive student program. This is a work-from-home position located anywhere within the continental US.


Responsibilities:
 

• Produce detailed actuarial and financial models which communicate near and long-term projections of financial performance of new and ongoing value-based  programs to facilitate corporate decision-making and the development of strategies and goals. 
• Analyze healthcare claims cost and utilization trends for use in projections defining savings methodologies for provider arrangements such as ACO & PCMH contracts, global capitation, bundled rates, episodic payments, capitation, risk adjusted total cost of care, and value-based payments. 
• Apply analytical and statistical software tools to summarize large healthcare data to glean findings and actionable insights.
• Forecast and interpret financial results, including variances from budget, to help identify medical cost improvement opportunities and potential risks as an individual or leading other analysts.
• Develop and gain support for data-based recommendations with team members from product, clinical, network, and strategy functions.
• Produce well-documented standard actuarial reports and projects.
• Present results of analyses and recommendations to leadership.
• Apply an understanding of complex actuarial concepts, methods, and applications in a variety of situations.
• Creatively leverage a wide range of datasets to inform key analyses.
• Collaborate with team members, including other healthcare actuaries, to ensure that work product meets the highest standards of quality.
• Build strong relationships with Actuarial, Analytics, Reimbursement, Clinical, and Finance teams across the enterprise.
• Provide analytical support for ad hoc data analyses.