Principal Actuarial Analyst
Health Care that Starts with You!
Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota's leading health plans. We provide more than 225,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs. UCare is growing in size, membership, products, geographic coverage, and employees. We're an organization that's going places. Be part of a team that cares about you, be part of UCare.
ABOUT UCAREAt UCare, we deliver high-quality health coverage and services to help members of all ages maintain and improve their health. It's a big job that takes innovative ideas, strategic partnerships, and a commitment to doing the right thing. Above all, it takes a compassionate team that is dedicated to making a real difference in the lives of our members and our communities.WORKING AT UCAREWorking at UCare is more than just a career; it's a mission. A mission that defines us as professionals, unites us as an organization, and shapes how we interact with our members and each other. Our values of integrity, community, quality, flexibility, and respect permeate every aspect of our organization - from who we are and how we act, to what we do and how we do it. We owe our continued success to our employees who proudly embody our mission and values in everything they do. PRINCIPAL ACTUARIAL ANALYST Position DescriptionThis position is responsible to provide financial analysis support to the organization and management. Support the Medicare Part D Bidding process with pharmacy data, assumption development and pharmacy trend reporting. Use programming knowledge to improve and streamline Medicare Part C and D bidding processes. Lead the Part D reconciliations with CMS. Develop and apply pharmacy acumen across UCare's lines of business. ·Update, manage and enhance pricing models for the annual CMS Part D Bidding process including base period development, IBNR estimation, risk adjustment bid impacts, and working directly with actuarial staff during bid development. Summarize historical Part D experience; prepare and discuss trend exhibits to establish bid trend projections.·Develop and maintain accurate data extracts used in the CMS Part D bids, PDE reporting and budgeting process. Support Pharmacy team with analysis of PDE issues/over-payments as needed.·Develop and maintain understanding of the CMS Part C Bidding process. Support Part C bid development on an ad-hoc basis. Use understanding of Part C bidding process to improve Medicare Part C bidding process. ·Establish and maintain a strong understanding of PDE reporting, pharmacy claim data and the relationship to CMS payment processes including the unique characteristics of product level benefit designs. ·Continue to grow and learn new programming skills that can be applied to provide ongoing financial analysis and support to management decision making, internal/external reporting, and ongoing financial/data support to internal customers.·Support the pharmacy claims projection development and forecasting in support of UCare's annual budget process. Prepare and discuss pharmacy trends with Pharmacy and Clinical staff. ·Establish and maintain a strong understanding of UCare product lines, reporting requirements, and health care industry. Grow and maintain relationship with UCare's PBM ·Represent Health Care Economics on UCare cross-departmental projects as an active contributor and supporting resource. ·Maintain appropriate documentation for departmental processes. ·Ad hoc analysis and backup support as needed. ·Other projects and duties as assigned.Education
B.S. in Computer Science, Actuarial Science, Statistics, or related field strongly preferred; demonstrated programming/financial analysis experience may be considered in leiu of degree.Required ExperienceIntermediate to advanced skills using Excel and SQL. Five years of health industry experience.Preferred ExperienceMedicare Part C and Part D bidding experience. Experience collaborating with IT to continuously improve technology tools. SAS experience.THE UCARE DIFFERENCEUCare is proud to be a recognized Star Tribune Top Workplace for the 8th consecutive year. As a part of our collaborative team, you'll experience the rewards that come with helping others and seeing the positive results of your hard work. We value and respect each individual's ideas and contributions, and give you the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, a myriad of volunteer activities, and a number of other rewards. If you're looking for a welcoming environment that celebrates what you have to offer, helps you build on your strengths, and gives you the opportunity to truly make a difference, we invite you to apply. As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.
Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You'll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis just minutes from major freeways and retail centers.
At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.