Associate Director Actuarial Services

Associate Director Actuarial Services

Job Title: Associate Director Actuarial Services

Location: 1 Optum Circle, Eden Prairie, MN 55344 (Telecommuting available from anywhere in the U.S.)

Work Type: Weekdays, Shift: First (Day), Hours Per Week: 40, Type: Regular

Salary Offered: $164,832.00 - $216,090.00 Yearly

Job Description:

Employer: Optum Services Inc.

Duties: Analyze statistical data and construct probability tables to forecast risk and liability for payment of future benefits. Produce quarterly internal forecasting and budgeting process for multiple clients; optimize and standardize the process across clients aligning model assumptions with industry standards; quantify the performance of value-based and shared savings arrangements by assessing medical loss ratios relative to a designated baseline year, while considering clinical acuity and material adverse changes; collaborate with finance teams to monitor performance against forecasts; analyze the causal factors behind differences, troubleshoot discrepancies arising from missing data, align on client deliverables, and effectively communicate actuarial concepts to non-actuarial audiences; work on the strategic evolution of pricing, utilization, and cost methodologies, along with underlying assumptions, integral to the refinement of forecasting and budgeting processes; conduct settlement reconciliations to assess incongruities between client's final settlements and Landmark's and factors driving variances; engage with clients to solicit supplementary information; conduct a retrospective forecast assessment, scrutinizing the accuracy of our predictions against actual runout across snapshots in time; discern patterns in risk score growth and medical expense savings, emphasizing key metrics including medical loss ratio, net savings, material adverse changes, and final settlement; enhance the stop-loss tail estimation methodology by developing continuance tables for the precise calculation of stop-loss amounts; create comprehensive documentation for all proprietary processes used for knowledge transfer and managerial review; deliver comprehensive presentations to the actuarial team on healthcare industry topics; and highlight specialized modeling considerations tailored to populations with distinctive conditions, such as end-stage renal disease. Telecommuting available from anywhere in the U.S.

Requirements: Employer will accept a Bachelor's degree in Mathematics, Economics, Actuarial Science, or related field and five (5) years of progressive, post-baccalaureate experience in job offered or in an analyst-related occupation. Position requires five (5) years of progressive, post baccalaureate experience in the following: Microsoft Excel and PowerPoint to build dynamic models and executive-level presentations; SQL expertise for querying, manipulating and validating large-scale claims and membership databases; SAS programming for data extraction, transformation and statistical analysis in an actuarial environment; Auditing and cleansing claims data to detect anomalies, reconcile discrepancies, and summarize findings; U.S. Medicare Advantage program, including CMS risk score methodologies, payment calculations, and reconciliation processes; Actuarial reserving techniques—development and analysis of lag triangles, loss ratio projections, seasonality adjustments, and IBNR estimation; and Forecasting models with proven ability to track performance against targets and explain drivers of variance for revenue, cost, and membership.