Analyze and monitor weekly incurred claims, paid claims, pharmacy, lab results, and authorizations to identify cost drivers and emerging trends.
Develop and implement actuarial studies and predictive models using large, complex datasets to forecast health claim activity and utilization patterns.
Translate complex data insights into clear, actionable intelligence for actuarial pricing, medical cost management, and finance teams.
Partner with data engineering and business stakeholders to expand data pipelines and enhance quality and usability of trend dashboards.
Drive improvements in early warning indicators for changes in healthcare trend.
Support preparations for executive-level summaries of findings to influence cost management strategies and financial planning.
Support and mentor analyst team members and collaborate with others across the enterprise on high-visibility projects.
Coordinate and direct special projects.
Requirements
Requires a BA/BS and to have passed a minimum of four Society of Actuaries (SOA) actuarial exams and a minimum of 3 years related experience; or any combination of education and experience, which would provide an equivalent background.
Strong technical background in SQL, Python, R, or SAS for data manipulation and statistical analysis.
Proficiency in Excel, Power BI/Tableau, and actuarial software tools.
Experience working with large administrative claims datasets and healthcare cost/utilization metrics.
Ability to apply actuarial judgment and statistical techniques to interpret and explain complex trends.