Manager, Actuary - Medical Cost Economics (Remote) at UPMC

Pittsburgh, Pennsylvania, United States -

Full Time

Start Date

Immediate

Expiry Date

30 Jan, 26

Salary

0.0

Posted On

01 Nov, 25

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Data Analysis, Medical Claims, Financial Modeling, Problem Solving, Communication Skills, Team Management, Health Economics, Actuarial Science, Strategic Thinking, Data Visualization, Trend Analysis, Budget Forecasting, Relationship Building, Analytical Skills, Adaptability, PC Skills

Industry

Hospitals and Health Care

Description

The Department of Health Economics is seeking a Managing Actuary! This credentialed healthcare actuary would drive high-visibility impactful analysis and would be responsible for developing and driving medical cost improvement strategies for UPMC Health Plan in close collaboration with leaders across the organization. This includes managing an experienced team responsible for analyzing medical cost utilization and unit cost data, developing strategies to improve experience relative to external benchmarks, evaluating and communicating leading indicators of financial performance, identifying top trend drivers and affordability opportunities, and supporting the development of strategies across cross-functional teams. The Managing Actuary will require a diverse set of skills and experience, including data and analytics expertise, a deep understanding of medical and pharmacy claims, broad-based business and health economics acumen, a strategic mindset, and an ability to influence and leverage cross-functional teams in a non-traditional actuarial environment. Strong organizational skills are essential to effectively manage multiple priorities, oversee complex projects, and ensure timely delivery of high-quality analytical outputs. This position will supervise 2-4 supporting staff, including actuarial analysts, in the performance of duties. As a Managing Actuary at UPMC, you will be given support for professional designations through continuing education opportunities. This is a work-from-home position located anywhere within the continental US with the potential for infrequent travel into Pittsburgh (up to 2-3 times a year) for meetings/conferences. Responsibilities: Partner with Health Plan senior leadership for creative problem-solving and strategic decision-making involving medical cost improvement strategies. Direct a team to produce detailed actuarial and financial models which communicate drivers of financial performance of all lines of business to facilitate corporate decision-making and the development of strategies and goals. Forecast and interpret financial results, including variances from budget, to help identify medical cost improvement opportunities and potential risks Analyze trends in spending and utilization. Develop and gain support for data-based recommendations with team members from product, clinical, network, and strategy functions. Bring clarity to complex problems using exceptional communication skills when engaging with senior leadership and technical audiences. Apply an understanding of complex actuarial concepts, methods, and applications in a variety of situations and deliver results to leadership. Creatively leverage a wide range of datasets to inform key analyses. Build strong relationships with Actuarial, Analytics, and Finance teams across the enterprise. Ensure that departmental work products meet the highest standards of quality. Manage and develop a team of 2-4 supporting staff including actuarial analysts. Bachelor's degree in mathematics, statistics, actuarial science, economics, or related field required. ASA or FSA certification by Society of Actuaries required; FSA preferred. Six and a half (6.5) years of experience in progressively more responsible actuarial work in health insurance/managed care or equivalent training/education. Management experience preferred. Experience with commercial and government health programs is preferred. In-depth understanding of health insurance market dynamics. Excellent problem-solving and analytical skills. Excellent oral and written communication skills. Adaptability and ability to prioritize effectively. Strong PC skills. Data retrieval skills and relational database experience. Data visualization experience is preferred. Licensure, Certifications, and Clearances: Licensure/Certification: ASA or FSA certification by Society of Actuaries required. Membership in the American Academy of Actuaries required. UPMC is an Equal Opportunity Employer/Disability/Veteran

Responsibilities

The Managing Actuary will drive impactful analysis and develop medical cost improvement strategies in collaboration with organizational leaders. Responsibilities include managing a team to analyze medical cost data and communicate financial performance indicators.