Alignment Health
Alignment Health
Alignment Health — Medicare бағдарламасына қатысушыларға, әсіресе қарт адамдарға, созылмалы аурулармен өмір сүретіндерге және әлсіз, ерекше күтімді қажет ететін жандарға медициналық көмекті жақсартуға бағытталған медициналық сақтандыру компаниясы. 2013 жылы құрылған компания жекелендірілген күтім үлгісін технологиямен және сенімді жергілікті қызмет көрсетушілермен қолдауды үйлестіретін тәулік бойы жұмыс істейтін кеңес беру тобымен ұштастырады. Оның қызметі денсаулық сақтау қызметтерін көрсету мен сақтандыру салаларын қамтиды және мүшелері үшін көмекті қолжетімді, жедел әрі шығынды ескеретін етуге бағытталған. Alignment Health Medicare қауымдастықтарының қажеттіліктеріне қызмет көрсететін өсіп келе жатқан денсаулық сақтау ұйымының әртүрлі бағыттарына қызметкерлер қабылдайды.

Actuarial Analyst II, Medicare Advantage

Support Alignment Health’s Medicare Advantage pricing, forecasting, and reserving work. Build actuarial models and turn healthcare financial analyses into recommendations.

Сипаттама

  • Build and maintain actuarial analyses, models, and reports for pricing, forecasting, reserving, risk adjustment, and financial planning.
  • Review claims, utilization, membership, risk scores, provider performance, and benefit experience to identify financial trends, risks, opportunities, and key drivers.
  • Prepare assigned portions of Medicare Advantage bid submissions, actuarial exhibits, and supporting materials.
  • Conduct monthly and quarterly reserve, accrual, and financial performance analyses; validate results, reconcile data, and explain significant variances.
  • Assess the financial effects of product, benefit, network, operational, and regulatory changes.
  • Develop and enhance actuarial models, tools, dashboards, controls, and documentation, applying sound data management, validation, and version control.
  • Share analyses, assumptions, results, and recommendations with actuarial leaders and cross-functional partners.
  • Offer technical guidance and review work prepared by less experienced analysts.
  • Take part in the Actuarial Development Program by pursuing exams, completing development activities, applying feedback, and putting new knowledge to use.

Талаптар

  • Bring 2–4 years of experience in actuarial work, healthcare analytics, insurance, financial modeling, or another relevant quantitative field.
  • Have experience working with large datasets, financial or actuarial models, and reporting tools.
  • Be able to plan and complete assigned analyses independently, check outputs, spot issues, and communicate findings.
  • Have experience explaining quantitative results to nontechnical partners and supporting their decisions.
  • Hold a bachelor’s degree in Actuarial Science, Mathematics, Statistics, Finance, Economics, or a related quantitative field, or have an equivalent combination of education and experience.
  • Actively participate in the Actuarial Development Program.
  • Have passed 2–4 actuarial examinations.
  • Demonstrate actuarial modeling, forecasting, and financial analysis skills.
  • Understand healthcare cost, utilization, membership, and risk adjustment analytics.
  • Work effectively across teams and manage stakeholder relationships.
  • Knowledge of Medicare Advantage is preferred.
  • Programming experience with SQL, R, or Python is preferred.

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