Highmark Health Jobs

Company :

Highmark Inc.

Job Description :

JOB SUMMARY

This job is a senior level actuarial analyst position. Participates in Highmark’s Actuarial Executive Development Program and is expected to make continued progress towards actuarial credential. Utilizes experience and industry knowledge to define & diagnose a problem, outline data requirements for a study or analysis, and devise potential solutions. Guides and mentors less experienced staff and provides decision support to team members while initiating and leading the development of actuarial studies, analyses, and presentation materials needed to appropriately inform decision makers and making appropriate recommendations to management. Will work to develop efficient processes and will apply actuarial techniques and statistical analysis to several functions which may include insurance premium and pricing development, claim trend analysis, experience studies, medical economics, profitability analysis, wellness studies, predictive modeling, provider efficiency, provider contracting analysis or claim reserving.

ESSENTIAL RESPONSIBILITIES

• Define & diagnose a problem. Outline data requirements for a study or analysis and devise potential solutions. Review the appropriateness of the results in light of experience and industry knowledge. Consider alternate explanations or viewpoints before drawing conclusions.

• Create studies, analyses, and presentation materials needed to appropriately inform decision makers. Make appropriate recommendations to management across teams within the actuarial department.

• Proactively ensure the internal and external consistency of all work. Use industry knowledge to perform reasonability checks as well as exceed customer expectations. Identify methods to test whether suspect results are correct.

• Take the initiative to utilize internal and external knowledge forums to gain broader industry perspective. Demonstrate subject matter expertise, and as a result is sought out by others for technical input on producing accurate and efficient work. Promptly and efficiently identify outliers and anomalies in the work of others. Seek continual feedback from manager and others in order to advance personal development and career goals.

• Understand the environment, goals, and objectives of the incumbent's own position, their team, and all internal customers. Use experience and industry knowledge to envision and implement new processes and propose changes to existing processes, leading to improved outcomes that better conform to corporate goals, objectives, and values. Demonstrate a capacity to shift between “big picture” and “detailed” thinking when analyzing issues and their strategic importance.

• Independently manage own time and resources across many projects. Demonstrate responsiveness, flexibility, and ability to independently prioritize when shifting from one task to another. Comfortable in a dynamic, changing environment. Approach new challenges with anticipation and a view towards success. Carry out recurring projects with minimal assistance and oversight. Keep manager informed.

• Interact with stakeholders in a manner that fosters cooperation and teamwork while conveying engagement and competence. Enhance department influence by providing responsive service and understanding customer needs. Effectively explain technical work to both technical and non-technical people and provide decision support to team members. Correctly interpret direct and indirect messages and verbal and non-verbal behaviors and respond appropriately.

• Guide and mentor less experienced staff on a regular basis in a manner that fosters teamwork and excellence. Listen, take direction, accept criticism and feedback and adjust behavior accordingly to improve performance. Demonstrate flexibility and proactively take on additional work as needed by the team, leading by example.

• Other duties as assigned or requested.

EDUCATION

Required

• Bachelor’s Degree or its equivalent in Actuarial Science, Mathematics, Statistics or closely related discipline

Substitution

• None

Preferred

• Master's Degree or its equivalent in Actuarial Science, Mathematics, Statistics or closely related discipline

EXPERIENCE

Required

• 3 years experience in an Actuarial role

• 6 Exam Components

Preferred

• 10 or more Exam Components

LICENSES AND CERTIFICATIONS

Required

• None

Preferred

• None

SKILLS

• Possesses and applies an in-depth knowledge of actuarial principles, concepts, practices and processes within multiple fields or disciplines

• Possesses significant expertise to complete complex assignments and ability to visualize, articulate, and solve complex problems while leading others to complete straightforward assignments

• Analytical Skills

• Oral & Written Communication Skills

• Problem-Solving

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Frequently

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Frequently

Audible Speech

Constantly

Hear

Constantly

Position self or move lower on ground, under tables/desks, etc.

Never

Climb

Never

Drive

Occasionally

Reach

Frequently

Sedentary position

Frequently

Move

Frequently

Repetitive Motion

Frequently

Use Hands/Fingers to Handle or Feel (beyond just data entry)

Frequently

Vision – Distinguish Color

Frequently

Vision – Far, Near, Depth Perception

Frequently

Move, transport, transfer – up to 10 lbs (Sedentary Work)

Occasionally

Move, transport, transfer – up to 20 lbs (Light Work)

Occasionally

Move, transport, transfer – up to 50 lbs (Medium Work)

Occasionally

Move, transport, transfer – excess of 50lbs (Heavy Work)

Never

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy.

Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, age, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, age, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.

EEO is The Law

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For accommodation requests, please contact HR Services Online at HRServices@highmarkhealth.org

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Req ID: J239431