Tufts Health Plan
Sr Actuarial Analyst
Tufts Health Plan, Boston, Massachusetts, us, 02298
Who We ArePoint32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.We enjoy the important work we do every day in service to our members, partners, colleagues and communities. To learn more about who we are at Point32Health, click
here .Job SummaryThis Senior Actuarial Analyst will support the Medicare Part C Pricing work. The key responsibilities for this role are pricing, rate filing (Medicare Advantage Bid) development, strategic analysis, and other ad hoc projects. This role will also work with various business partners outside of Actuarial to support their pricing requests.
An understanding of the health insurance industry as well as proficiency in Excel and statistical modeling is required. The position is eligible to participate in the Actuarial Student Program, including job rotations and comprehensive support of the pursuit of Fellowship in the Society of Actuaries. This position can be fully remote or hybrid in our Canton office.Key Responsibilities/Duties – what you will be doingSupport the preparation, analysis, and submission of Medicare Advantage bids, ensuring compliance with CMS regulations.Maintain current models to assist with the bid pricing process and develop new models as needed to fit changing needs.Create code to pull in data needed for various models. Validate and audit the data as needed to ensure accuracy.Collaborate with business partners teams, including finance and product development to provide support for strategic decisions.Projects are focused on the Medicare Preferred population and support the goal of providing Medicare products that are competitively priced and increase the quality of care provided to our members. The individual will meet these needs through the use of various software packages including SAS, Excel, and PowerPoint. Day-to-day work is a combination of new projects, maintaining existing projects, and standard reporting.Qualifications – what you need to perform the jobQualifications (Minimum education & experience level required):College degree required4+ years experience3+ examsSkill requirements (include complexity of position):Analytic:
Demonstrates experience and aptitude in analytic project design through design and build of complex technical applications. Improves existing models/code in the most appropriate and efficient manner.Technical:
Proficiency in the use of MS Excel and relational databases or statistical packages such as SAS. A solid understanding of SQL is a plus.Communication/Presentation skills:
Well-developed verbal and written skills. Packages and presents results to business leaders to demonstrate the link between analysis and broad business context. Ability to facilitate planning and review sessions.Negotiation/Leadership skills:
Able to operate in a matrix environment. Able to implement Actuarial department standards and processes. Mentors and trains more junior staff.Independence/Judgment:
Receives limited management oversight of selected tasks, projects and processes. Manages time to meet deadlines, raises questions as they come up, and communicates progress to manager. Identifies reasonable conclusions/assumptions and vets with manager to get feedback and reach agreement.Interpersonal skills (include personal interaction):
Must be able to work cooperatively as a team member. Regular interface with various levels of staff and management is required.Compensation & Total Rewards OverviewAs part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Company's sole discretion and may be modified at the Company’s sole discretion, consistent with the law.Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes:Medical, dental and vision coverageRetirement plansPaid time offEmployer-paid life and disability insurance with additional buy-up coverage optionsTuition programWell-being benefitsFull suite of benefits to support career development, individual & family health, and financial healthFor more details on our total rewards programs, visit
https://www.point32health.org/careers/benefits/Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health EquityPoint32Health is committed to making diversity, equity, inclusion, accessibility and health equity part of everything we do—from product design to the workforce driving that innovation. Our Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity team's strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
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here .Job SummaryThis Senior Actuarial Analyst will support the Medicare Part C Pricing work. The key responsibilities for this role are pricing, rate filing (Medicare Advantage Bid) development, strategic analysis, and other ad hoc projects. This role will also work with various business partners outside of Actuarial to support their pricing requests.
An understanding of the health insurance industry as well as proficiency in Excel and statistical modeling is required. The position is eligible to participate in the Actuarial Student Program, including job rotations and comprehensive support of the pursuit of Fellowship in the Society of Actuaries. This position can be fully remote or hybrid in our Canton office.Key Responsibilities/Duties – what you will be doingSupport the preparation, analysis, and submission of Medicare Advantage bids, ensuring compliance with CMS regulations.Maintain current models to assist with the bid pricing process and develop new models as needed to fit changing needs.Create code to pull in data needed for various models. Validate and audit the data as needed to ensure accuracy.Collaborate with business partners teams, including finance and product development to provide support for strategic decisions.Projects are focused on the Medicare Preferred population and support the goal of providing Medicare products that are competitively priced and increase the quality of care provided to our members. The individual will meet these needs through the use of various software packages including SAS, Excel, and PowerPoint. Day-to-day work is a combination of new projects, maintaining existing projects, and standard reporting.Qualifications – what you need to perform the jobQualifications (Minimum education & experience level required):College degree required4+ years experience3+ examsSkill requirements (include complexity of position):Analytic:
Demonstrates experience and aptitude in analytic project design through design and build of complex technical applications. Improves existing models/code in the most appropriate and efficient manner.Technical:
Proficiency in the use of MS Excel and relational databases or statistical packages such as SAS. A solid understanding of SQL is a plus.Communication/Presentation skills:
Well-developed verbal and written skills. Packages and presents results to business leaders to demonstrate the link between analysis and broad business context. Ability to facilitate planning and review sessions.Negotiation/Leadership skills:
Able to operate in a matrix environment. Able to implement Actuarial department standards and processes. Mentors and trains more junior staff.Independence/Judgment:
Receives limited management oversight of selected tasks, projects and processes. Manages time to meet deadlines, raises questions as they come up, and communicates progress to manager. Identifies reasonable conclusions/assumptions and vets with manager to get feedback and reach agreement.Interpersonal skills (include personal interaction):
Must be able to work cooperatively as a team member. Regular interface with various levels of staff and management is required.Compensation & Total Rewards OverviewAs part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Company's sole discretion and may be modified at the Company’s sole discretion, consistent with the law.Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes:Medical, dental and vision coverageRetirement plansPaid time offEmployer-paid life and disability insurance with additional buy-up coverage optionsTuition programWell-being benefitsFull suite of benefits to support career development, individual & family health, and financial healthFor more details on our total rewards programs, visit
https://www.point32health.org/careers/benefits/Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health EquityPoint32Health is committed to making diversity, equity, inclusion, accessibility and health equity part of everything we do—from product design to the workforce driving that innovation. Our Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity team's strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.
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