AvMed Actuary Analyst II - AvMed (Gainesville, FL) in Gainesville, Florida For Sale
SCOPE OF POSITION:
This position is responsible for developing and implementing premium pricing methodologies for all AvMed products and business lines. This position oversees all of the financial, actuarial and competitor analysis activities necessary for the development of pricing strategies and tactical business decisions related to product pricing.
ESSENTIAL JOB FUNCTIONS:
Conduct analysis of premium rates and assist in the development of product pricing and premium rate filings to the Florida Office of Insurance Regulation (OIR) for all product lines. Work with key Company personnel to obtain cross-functional input to implement AvMed s product pricing strategy and tactics, consistent with Underwriting, Marketing and overall Company goals and objectives.
Oversee and participate in the pricing of existing and new products, benefits, and group-specific benefit designs.
Provide routine reports and/or conduct studies for the purposes of monitoring adequacy of pricing factors and assumptions.
Analyze product and segment performance, incorporating both historical observation and insight into prospective trends. Develop business plans containing forecasts of future financial performance.
Manage and perform monthly analysis identifying opportunities to reduce medical cost and utilization and provide recommendations to senior management. Research, evaluate and analyze medical care cost trends by region, market segment and product line and conduct variance analysis with respect to utilization and unit costs.
Work with the Vice President and Chief Actuary in developing a standard collection of supplemental trend exhibits, examining items such demographics, product mix, contract mix, medical risk score, etc.
Support the Vice President and Chief Actuary and Finance department personnel in assessing and evaluating the adequacy of Company claim liability reserves.
Manage and develop AvMed s annual Medicare product line bid submission to the Centers for Medicare and Medicaid Services (CMS).
Work collaboratively with Underwriting towards the development of underwriting guidelines and policies conducive to profitability and the avoidance of adverse selection.
Develop and manage the competitor intelligence function to help the organization better understand key competitors use such information to develop pricing and rate development strategies and tactics.
Provide data analysis and analytical support to the departments reporting to the Senior Vice President of Underwriting, Actuarial & Regulatory Affairs. Maintain data integrity, evaluate alternatives for accessing data and develop data models and templates for use within multiple departments.
Participate in the development, coordination, implementation, and maintenance of operational systems and reporting tools for use by the Commercial Group and Individual Underwriting departments to include automated rating systems, CRM systems and actuarial tools. This also includes upgrades and modifications to current financial and managed care systems that directly or indirectly impact the Underwriting and Pricing operations.
Perform duties related to the Federal Employee account including annual development of renewal premium rate and annual rate reconciliation in accordance with regulatory guidelines.
Provide support and guidance for regulatory audit activities impacting all departments reporting to the Senior Vice President of Underwriting, Actuarial & Regulatory Affairs including OIR Market Conduct Exams, Medicare Bid audits and OPM audit.
Interact with outside actuarial consulting expertise as needed.
Maintain a detailed repository of the routine deliverables and activities of the department.
Develop the capabilities of direct reports by providing education and guidance.Implement a pervasive and proper level of process documentation to be carried out by all direct reports.
NON-ESSENTIAL JOB FUNCTIONS:
Perform additional duties and responsibilities as assigned by management.
Recognize and observe all company and departmental policies and procedures.
Focus on achieving departmental and organizational objectives.
Maintain professional appearance by complying with dress code in an appropriate manner.
Complies with company policies and procedures, which includes punctuality as they relate to work time, lunch, and break periods
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