Job Description

DESCRIPTION

Amazon One Medical is hiring a Actuarial Manager Analyst. Actuarial rigor is one of the keys to our success. This candidate will responsible primarily for several critical workstreams which include analysis of Medicare Advantage and Accountable Care Organization data, design and implement an actuarially sound monthly reserving process for Total Medical Expense (TME) estimation, and lead continuous evaluation of TME performance compared to plan expectations.

Key job responsibilities
-Analysis of Medicare Advantage and Accountable Care Organization data primarily
-Medical economics reporting and ad-hoc analysis relating to cost of care management
-Medicare Risk score projections and premium estimation
-Design and implement an actuarially sound monthly reserving process for Total Medical Expense (TME) estimation
-Lead continuous evaluation of TME performance compared to plan expectations
-Coordinate with the finance team on future TME projections that are refreshed monthly and provided quarterly for forecasting and planning
-Support month end financial and accounting processes for relevant actuarial estimates.
-Value based care contracting support and ongoing financial and risk analysis.
-Support ongoing actuarial support for outside auditor review of financial estimates and results.
-Design studies to monitor the suitability of the completion factor estimates.
-Lead continuous evaluation of risk based funding and scoring performance compared to plan expectations.
-Complete the evaluation of stop-loss coverage and manage third party vendors
-Analyze and develop new to market assessments and modeling which includes future Medicare geographic expansion and enhancements / changes to other market segments (Commercial potentially)

BASIC QUALIFICATIONS

- 6+ years of data scientist experience
- Associate of the Society of Actuaries (ASA) is required -Experience with Medicare or Medicare Advantage products -Strong knowledge of actuarial reserving, forecasting and medical economics -Expertise in working with medical claims data and using programming languages such as SQL, R, SAS, Python, Snowflake, Tableau/Looker -Ability to work cross functionally and communicate effectively with stakeholders (Operations, Finance, Planning, & Accounting (FP&A), Clinical, etc.) -Bachelor's degree is required

Job Tags

Full time,

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